If we know that bladder cancer results from damage to a cell’s genes, can’t we just fix the genes? There has been much excitement in recent years about our growing understanding of genetics and the potential to use “gene therapy” to cure a variety of diseases, including cancer. Although gene therapy is not currently advanced enough to treat bladder cancer, many people are working very hard to make it a reality.
The ability to treat bladder cancer with gene therapy is hindered by two basic problems. First, in order to “cure” the cancer, the genes must be inserted into every cancer cell. This is an unrealistic goal, but a less than 100% effect could still be helpful to patients. Second, there is not just a single genetic problem that causes bladder cancer. Bladder cancer results from damage to multiple genes, but not necessarily the same genes in each patient. This makes gene therapy exponentially more difficult.
Several strategies are now being pursued to make gene therapy a reality. The most promising are to use gene therapy in addition to current treatments. The goal will not be to cure the cancer directly but rather to amplify the normal response to treatment such as BCG, radiation, or chemotherapy. Early trials have shown that the approach is feasible, although several technical barriers must be overcome before it is approved for general use.