Thermochemotherapy Better Than Standard Chemo for Bladder Cancer Applying local microwave hyperthermia while delivering intravesical mitomycin C is better than chemotherapy alone at preventing recurrence of superficial transitional cell carcinoma of the bladder following surgical resection, new prospective study findings indicate. Even after transurethral resection and adjuvant intravesical chemotherapy or immunoprophylaxis, there is a high rate of recurrence of transitional cell carcinoma (TCC), Dr. Renzo Colombo and colleagues note in their paper, published in the Journal of Clinical Oncology for December. Thermotherapy using a transurethral radiofrequency applicator has been shown to be safe and effective as an alternative to surgical resection. For their current report, Dr. Colombo, at University Vita-Salute in Milan, Italy, and associates enrolled 83 patients with primary superficial TCC or recurrent TCC following complete resection. Forty-one patients were randomly assigned to treatment with mitomycin C alone and 42 to thermotherapy using the Synergo 101-1 system (Medical Enterprises, Amsterdam) plus mitomycin C. Patients underwent an induction cycle of eight weekly sessions. These were followed by a maintenance regimen of four monthly sessions, in which 20 mg mitomycin C was administered for 1 hour, with or without hyperthermia delivered at 42 degrees centigrade. Three patients in the hyperthermia group and five in the chemo-only group withdrew before the end of the 24-month study. Among the 75 remaining patients, there were 25 (57.5%) recurrences in the chemo only group and six (17.1%) in the thermochemotherapy group (p = 0.002). Patients in the thermotherapy group experienced more pelvic pain during treatment and thermal reaction of the posterior wall; lesions healed spontaneously. The authors note, however, that none of the patients terminated the protocol treatment because of pain. In an accompanying editorial, Dr. Donald L. Lamm maintains that thermochemotherapy "may represent a major improvement in the management of superficial bladder cancer." Dr. Lamm, a urologist at Mayo Clinic in Scottsdale, Arizona, notes that current optimal intravesical therapy was not administered, so it remains to be seen how combining hyperthermia with best practice will ultimately impact the management of superficial bladder cancer. J Clin Oncol 2003;21:4259-4260,4270-4276. Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.