Chemoresection in Non-Muscle Invasive Bladder Cancer

Non-muscle invasive bladder cancer (NMIBC) is the most common type of bladder cancer. It affects about 3 out of 4 people with the disease. An emerging therapy may give people living with this form of bladder cancer another treatment option.¹

While people with NMIBC are likely to recover from the disease, there is a real chance it will return (recur). Depending on how much the cancer has grown, this type of cancer has a 30 to 80 percent recurrence rate. Because bladder cancer comes back so often and can be aggressive, tumors are hard to treat.¹

Now, a new approach called chemoresection (or chemoablation) offers a more targeted therapy without the risks of surgery.

What is chemoresection for bladder cancer?

The standard treatment for NMIBC is surgery to remove a tumor. This procedure is known as transurethral resection of bladder tumor (TURBT). After the surgery, a doctor injects cancer-killing drugs (chemotherapy) into the bladder. This is a treatment called intravesical therapy. The drug stays in your bladder for an hour or 2 until you urinate.²

Bladder cancer chemoresection is a different type of intravesical therapy. Instead of injecting the drug into the bladder, the doctor inserts it into the tumor, directly targeting cancerous tissue. The goal of this approach is to avoid surgery completely.³

Chemoresection is also different from the type of chemo injected into the veins. That type, called intravenous chemo, works throughout your entire body and can damage healthy tissue.³

What are the benefits of chemoresection?

Chemoresection could have several advantages over standard intravesical therapy. Research shows a decrease in illness with this therapy. It also may prevent the need to remove the bladder.³

The treatment helps people with NMIBC avoid surgery, which requires medicine that puts them to sleep (anesthesia). This means less risk for people who are more likely to have complications from surgery, such as older adults and people with other health problems.^1,3

Lower cost is another benefit of this type of therapy. With standard treatment, there are operating room costs, hospital stays, and other related charges. Expenses can add up. And if the cancer returns, they balloon even further. Chemoresection can greatly lower the cost of treatment since it is considered a type of medicine.¹

What are the drawbacks of chemoresection?

Research shows that chemoresection may not work as well as surgery in people with recurring NMIBC. And although the treatment has lower rates of side effects than surgery, it is not yet clear how safe it is.¹

One scientific review suggests that doctors should use chemoresection only for people not well suited for surgery. This may change once more research has been done on the therapy.¹

The future of chemoresection for bladder cancer

While chemoresection shows promise, doctors have not widely adopted it to treat NMIBC. Most research into the therapy has been limited to small numbers of people with cancer. And there has been inconsistent follow-up and assessment of people who have used it.³

But this may change in the future. The US Food and Drug Administration (FDA) has approved one of the drugs used in chemoresection, mitomycin, for upper tract urothelial cancer (UTUC). This form of urinary cancer affects the lining of the kidney or ureter.³

For now, researchers continue to study the safety and effectiveness of this treatment for NMIBC.