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Men’s Health: Tackling Bladder Cancer

Movember’s focus on men’s health often highlights prostate cancer. But did you know smoking is the top risk factor for developing bladder cancer, the fourth most common cancer in men, and the fourth most common cancer overall in Connecticut?

“Bladder cancer is an overlooked cancer,” said Daniel Petrylak, MD, a medical oncologist who cares for patients at the Smilow Cancer Hospital Care Center at Greenwich. He is chief of Genitourinary Oncology at Yale Cancer Center (YCC) and an international pioneer in the research and development of new treatments for bladder and prostate cancers. Men comprise an estimated 70 percent of all cases.

Smoking causes about half of all bladder cancers, with smokers three times as likely to get the disease than non-smokers. “The same carcinogens going to your lungs find a way out of the body through the bladder,” said Dr. Petrylak, a professor of Medicine (Medical Oncology) and Urology at Yale School of Medicine. Most bladder cancers are non-invasive, attacking only the wall lining. More lethal types spread into deeper layers in the bladder or to nearby tissues and lymph nodes outside the bladder.

For decades, treatment options have been extremely limited for patients, particularly those who become resistant to therapy. Now that’s all changing. “An explosion of treatment options for bladder cancer in the past 10 years are improving survival rates for patients with advanced bladder cancer. Yale has been on the forefront of these treatments,” said Dr. Petrylak. “These treatments are available in Greenwich at the Smilow Cancer Hospital Care Center and throughout the Smilow Cancer Network.”

Dr. Petrylak led a clinical trial of an experimental drug that led to significant, rapid tumor shrinkage in patients with advanced bladder cancer who had been previously treated with immunotherapy and chemotherapy. Known as “smart bombs,” this infused medication targets a specific protein on the surface of tumor cells with a load of powerful chemotherapy, he explained. The drug is enfortumab vedotin.

He encourages men to speak with their primary care physicians if they experience pain during urination, bloody urine, urinary tract infections, and pelvic pain. “Treatment is a shared decision between the physician and the patient,” said Dr. Petrylak. “We continually strive to identify new treatment options and bring hope to our patients.”