New hope for victims of ‘Cinderella cancer’ that kills in months
BLADDER cancer patients have been given fresh hope of a longer life thanks to a new drug that encourages the immune system to destroy tumours. The drug, atezolizumab, can help those with an advanced form of the disease survive an average of almost 16 months compared to a survival rate of only 7.9 months for patients on conventional chemotherapy. Some patients are still alive two to three years after starting the new treatment.
Currently, many will die within months of diagnosis if they fail to respond to chemotherapy.
Bladder cancer strikes around 10,000 people a year in the UK, and around one in ten of them will discover the disease has already spread when they are first diagnosed.
The chances of still being alive five years after diagnosis are as low as 15 per cent if tumour cells have already migrated to other parts of the body.
Singer Andy Williams who had a string of hits in the 1950s and 60s – including Moon River – died from the disease in 2012, aged 84.
Atezolizumab is one of many immunotherapy drugs being developed to treat a range of cancers. Unlike chemotherapy, which works by poisoning cancer cells, immunotherapy harnesses the immune system to fight the disease.
The drug is also being tested as a possible treatment for non-small cell lung cancer, the most common form of the disease, which affects 40,000 people a year in the UK.
The drug, which is injected gradually for an hour once every three weeks, blocks PD-L1, a molecule found on the surface of cancer cells that camouflages them from detection and destruction by the immune system. Oncologists say it is the first new effective treatment in bladder cancer for more than 20 years.
Professor Syed Hussain, an oncologist specialising in urological cancers at Plymouth’s Derriford Hospital, said: ‘We now have hope. Until now, the outlook was pretty grim for those with advanced bladder disease who had not responded to chemotherapy.’
The drug is expected to be licensed next month in England and Wales, where it is also being considered by NHS spending watchdog NICE to see if it can be made available to desperate patients under the Cancer Drugs Fund. The drug would need the additional approval of the Scottish Medicines Consortium before it could be prescribed north of the Border.
Professor Hussain started trials of the therapy while working at Royal Liverpool Broadgreen University Hospitals NHS Trust.
He said: ‘Bladder cancer is a Cinderella cancer that does not make the news much. It’s a silent cancer and because it is largely symptomless we find a significant number of patients have cancer that has spread outside the bladder. The outlook is not good for this group. They’ll be dead within a year if the standard treatments fail.’
One patient who has bucked the trend is Kevin Wilson, a 64-year-old construction manager from Liverpool, who was placed on atezolizumab by Professor Hussain more than three years ago. Mr Wilson said: ‘It’s been my life saver. I wouldn’t be here now but for this drug. I’m very fortunate.’
THE father-of-three didn’t notice anything wrong until he saw blood in his urine. He was diagnosed with a urine infection but after symptoms persisted a scan showed cancer, which had advanced through his bladder wall.
By Christmas 2013, Mr Wilson had received chemotherapy to shrink the tumour and his bladder had been removed. But when tests the following year showed three tumours in his lungs, he was told his only chance of long-term survival was the as yet unlicensed drug. He said: ‘I was a young man – only 61 – with lots to live for, so I said yes, I’d have it.’
He remained on the drug for more than two years and, since coming off it, he remains cancer free.
He added: ‘The tumours were shrunk by half by the drug. They are still in my lungs but there is no sign that they are active. Now I feel well and I’m getting on with life.’
Allen Knight, chairman of charity Action Bladder Cancer UK, said: ‘Bladder cancer has one of the highest mortality rates of any common cancer – more than 50 per cent of those diagnosed will die. Those that will receive this drug have no other treatment options or hope.’