Thousands of NHS patients with bladder cancer are set to benefit from a drug that offers new hope for a cure.
In the decision, UK health chiefs approved nivolumab for patients who have not responded to treatments such as chemotherapy.
Doctors usually give a course of chemotherapy after removing the bladder tumor to kill any remaining cancer cells.
But there is no alternative for patients who cannot receive chemotherapy because of the side effects of disability, so their cancer usually returns within a year.
However, trials have shown that nivolumab, which helps the body’s immune system seek out and destroy cancer cells, prevents the disease twice this time.
Some patients remain cancer-free for up to three years after stopping the drug.
Professor Tobias Arkenau, consultant oncologist at the Sarah Cannon Research Institute in London, said: ‘Most of my bladder cancer patients cannot tolerate chemotherapy. After surgically removing the possible, they have to cross their fingers and hope it doesn’t come back.
A new drug is thought to offer hope to patients who fail chemotherapy (pictured)
“But this drug works incredibly well, and the side effects are less serious.”
More than 10,000 Britons are diagnosed with bladder cancer each year. If it is detected early, patients are usually offered minimally invasive surgery, in which the tumor is excised using instruments that pass through the urethra to the bladder. A short course of chemotherapy is given to clear any remaining cancer cells.
But about a quarter of bladder cancers are diagnosed later, in the second stage, when the tumor has begun to grow into the muscle lining that lines the bladder. These patients are offered radiotherapy to shrink the cancer or invasive surgery to remove the organ as well as surrounding tissue.
Artist Tracey Emin opened up about her major bladder cancer treatment in 2020, which involved removing several pelvic organs, including her bladder, using a urostomy bag to urinate.
Cancer cells remain in every fifth patient who undergoes bladder surgery. Chemotherapy can be given to kill them, but about a third of patients are elderly or in poor health and cannot cope with severe side effects.
Instead, they are closely monitored and treated only when the cancer comes back. It occurs within two years in almost half of patients, making it more difficult to treat.
Dr Robert Huddart, professor of oncology at the Institute of Cancer Research in London, said: ‘Relying on scanners to detect small cancers can only go so far. A small lump is easy to miss. That’s why it’s so important that we have a treatment that kills the cancer cells that are right next to each patient.
Nivolumab is the first treatment to offer hope for a cure to this group. The drug, given as a drop every two weeks for up to a year, works by disabling proteins called PD-L1 that attach to the tumor and make it invisible to the immune system’s fighting cells. This “turning off” of proteins allows the immune system to spot and attack the cancer.
Artist Tracey Emin (pictured) has opened up about a major bladder cancer treatment in 2020.
PD-L1 proteins have been implicated in many other tumors, and nivolumab has been shown to work similarly in other cancers. NHS patients with skin cancer, kidney cancer and some head and neck cancers can be treated with the drug. Side effects are usually mild, most commonly itchy skin, diarrhea and fatigue.
Dr Syed Hussain, professor of oncology at the University of Sheffield, who took part in the nivolumab trial, said: “I treated a 60-year-old man with nivolumab and two years later there was no sign of cancer.
“Best of all, he had an excellent quality of life with the drug, with almost no side effects. It was very surprising.
“It’s clear that patients on nivolumab can go about their daily lives happily, which is much more difficult with chemotherapy.”
Weird Science: Children who become boys when they grow up
There is a village in the Caribbean where many boys do not develop genitalia until puberty.
The boys, called Gavedoces, which translates to 12-year-old penis, are born with female genitalia due to a lack of hormones.
Typically, babies in the womb are neither male nor female until eight weeks after sex hormones are released.
In boys, testosterone is converted into a powerful hormone called dihydro-testosterone, which stimulates the development of the sex organs.
But Hevedocs lack the enzyme that triggers this process, so they appear female at birth and grow up that way.
Only when they reach puberty and the second surge of testosterone does the body respond.
Your amazing body
Scientists believe that a wrinkled hand in water is an evolutionary advantage
Long soaks in the tub wrinkly wrinkly fingers and toes – but this feature of our bodies may have once served an important purpose.
According to experts, the ridges that form on the skin gave our ancestors an evolutionary advantage, helping them to hold on to wet objects or surfaces, such as on car tire treads.
Wrinkles occur when the brain sends signals to the blood vessels under the skin, telling them to constrict.
This reduces blood flow to the fingers and toes, causing them to shrink slightly and cause loose skin folds.