The term "bladder cancer" refers to tumors that arise in the lower urinary collecting system.
More than 90 percent of these cases in the United States are transitional cell carcinomas that arise in the cells of the bladder’s inner lining.
Less common are the squamous cell carcinomas that form in thin, flat cells and the rare adenocarcinomas, that arise in glandular cells. Both of these types typically result from long-term infections or irritation.
The transitional cells that line the bladder form an inner cell layer that begins in the kidneys, and extends down the ureters to the bladder and ending at the urethra.
Kidney cancers—known as renal cell carcinomas—arise within the body of the kidney, not the collecting system.
According to the American Cancer Society (ACS), more than 60,000 people in the United States are diagnosed with kidney cancer annually.
Most of these tumors are known as clear cell carcinomas, which over-produce proteins associated with the formation of blood vessels. It is now known that a mutation in the Von Hippel Lindau (VHL) gene is responsible for most of these cancers.
Less common forms include papillary (both familial and non-familial) and chromophobe tumors.
Almost 75 percent of people with bladder cancer have a non-invasive form and can be treated with either surgery or radiation.
In more advanced cases, chemotherapy is administered to prevent recurrence or control metastatic disease.
The drugs with activity in bladder cancer include cisplatin and carboplatin, doxorubicin, Mitomycin-C, 5 FU, cytoxan, interferon, Taxol and gemcitabine.
The activity of immunotherapy for this disease has added a new dimension to the treatment of this disease with some patients responding to the PD-1, PDL-1 checkpoint inhibitors.
Also, good activity is seen with many drug combinations.
When bladder tumors are removed, we can study them in our laboratory to examine the activity of each of the drugs and combinations of interest.
Discovered early, kidney cancer can be cured with surgery.
A patient may have an entire kidney removed (the body can function effectively with only one kidney) or may undergo nephron-sparing surgery for a partial kidney removal.
As the ACS points out, kidney cancer cells are usually resistant to chemotherapy.
Nonetheless, some chemotherapeutic agents (such as vinblastine, floxuridine, 5-fluorouracil (5-FU) and capecitabine) have been shown to help in a small number of patients.
The development of newer classes of drugs known as the VEGF antagonists that include the monoclonal antibody Bevacizumab and small molecule drugs like Sunitinib, Sorafenib, Axitinib, Pazopanib, and Cabozantinib. In addition, the mTOR inhibitors can offer benefit to a growing number of patients with this disease.
Immunotherapy has revolutionized the management of kidney cancer with good and sometimes durable responses seen with the same checkpoint inhibitors that are used in bladder cancer.
Many of these agents used in these diseases can be tested in our laboratory by Ex-Vivo Analysis of Programmed Cell Death (our EVA-PCD assay) to determine efficacy and combination effects.
Call us at 800-542-4357 or email us via our Contact Us page to find out how we can test your cancer cells which enables us to identify those drugs and combinations most likely to be effective for treating your bladder or kidney cancer.
After three months of conventional treatment for metastatic kidney cancer at Stanford, where he was surrounded by colleagues, he was not responding to therapy.
He stopped producing red blood cells. He checked out of the hospital and was driven to Rational Therapeutics (now Nagourney Cancer Institute), where he arranged to have a lymph node removed for a functional profiling assay.
The test, or “FUNCTIONAL PROFILE” of my tumor, led to a recommendation for a combination of three conventional anti-cancer drugs. However, none are drugs of choice for kidney cancer; none of them would have been used as “standard” therapy.
— John Friedberg, MD