Precision therapy improves bladder cancer survival

There are about 400 new cases of bladder cancer in Hong Kong every year, which are more common in people aged 55 to 70, and are more common in males. The first-line treatment for advanced bladder cancer is cisplatin chemotherapy, which is generally effective. It turns out that one-fifth of patients with diffuse bladder cancer have FGFR gene mutations. When first-line treatment is ineffective, relevant targeted drugs can be considered to help improve survival.

Liang Guangquan, a specialist in clinical oncology, said that more than 90% of bladder cancers are urothelial cancers, and urothelial cells can be found in the renal pelvis, ureter, urethra and bladder. Diseases are often present.

blood in urine

The most common symptom of patients is blood in the urine. Liang Guangquan pointed out, “The most typical situation of early bladder cancer is that the urine is clear and normal, but the last few drops of urine will be bloody when they come out with force, and it may not be painful.” In more severe cases, the entire urination process will appear bloody, or even form blood clots, the bladder will feel distended and painful, and urination will be difficult. “Although the situation is similar to cystitis, bladder stones, etc., but generally patients with hematuria will seek medical attention, and the diagnosis is usually in the early stage.”

low response rate to chemotherapy

In the early stage of bladder cancer, chemotherapy drugs or BCG can be injected into the bladder, or cystoscopic surgery. Artificial bladder. For patients whose cancer cells have spread, cisplatin chemotherapy is considered first in first-line treatment, but the overall survival rate after first-line treatment is only about 7 to 9 months, and the objective response rate is only about 10%. Immunotherapy or chemotherapy, the response rate is only about 20%, and the disease control ability is limited.

Genes should be tested first

In recent years, many cancers can be precisely treated by matching appropriate targeted drugs through genetic testing. There are also suitable treatment options for bladder cancer. Liang Guangquan continued, “Currently, bladder cancer biomarkers include FGFR, HRR, and TMB. According to statistics, one out of every five patients with invasive bladder cancer has FGFR gene mutation, and conventional treatment has limited effect on such patients. There are targeted drugs registered for this gene mutation, which can be used for second- or third-line treatment.” The response rate of the new targeted drugs is more than half, which can help control tumor growth and improve patient survival. “It is suggested that patients can do genetic testing before first-line treatment, and after treatment, they will know whether there is a suitable target drug, so as to increase the treatment effect.”

Drink more water and reduce tobacco and alcohol

Liang Guangquan shared the case of a 50-year-old patient. “His illness was related to his type of work. Because he was a professional driver, he was afraid that he would often have to go to the bathroom and rarely drink water. He also had a history of kidney stones and developed bladder cancer over time.” Bladder stones and chronic bladder inflammation are one of the risk factors for bladder cancer, so drink plenty of water on weekdays to reduce related risks. In addition, reducing smoking and exposure to second-hand smoke, eating less preserved or preservative foods, and eating more fruits and vegetables can help prevent bladder cancer. “It is advisable to reduce exposure to bleaching agents and organic solvents in daily life. If you are involved in work such as textiles, hair dyeing, leather, printing, etc., you should take protective measures and do regular health checks.”