For the past 30 years, there have been no significant changes in the treatment of bladder cancer, but that appears to be changing, thanks to the advent of immunotherapy, a top doctor says.

 “It’s incredible to be trained in an environment where death from invasive bladder cancer was the rule, and not the exception, to see the pendulum swing so far,” Dr. Arjun Balar tells Newsmax Health.

Balar is a medical oncologist who specializes in invasive bladder cancer at NYU Langone Medical Center in New York City. He is one of the researchers involved in a new clinical study of an experimental drug called atezolizumab.

The clinical trial looked at about 300 patients with invasive bladder cancer. The patients had all been previously treated, but their cancer had returned.  But, after being treated with atezolizumab, the tumors in 15 percent of the patients shrank,  Balar says. Not only that, but also some disappeared completely.

“These patients ask me if they are cured, but I can only tell them that time will tell,” says Balar.

One of the participants is Louis (Lou) Pagano, 61, who lives in a suburb of Philadelphia. He was diagnosed with bladder cancer in 2013, underwent chemotherapy to shrink the tumor, then had his bladder removed. Despite this, several new tumors – including one in his pelvic region – popped up.  Cancer cells were also spotted in his lymph nodes and his liver.

These signs indicated that the cancer had spread to distant parts of his body, and Pagano's chance of survival had dropped to a dismal five percent. 

“I asked my oncologist if she had any patients still alive with this that she was treating, and she told me 'no,' ” Pagano recalls. But he was determined to survive.

“I thought about my wife, my children and my grandchildren, so I wasn’t going to roll over,” he recalls. So he enrolled in the atezolizumab trial. 

Now, Pagano is not only alive, but most signs of his cancer have vanished.

Immunotherapy, which is credited with saving the life of former President Jimmy Carter, is currently approved for the treatment of melanoma and advanced lung cancer.  Companies like Roche’s Genentech, which developed atezolizumab, are racing to develop such therapies for bladder cancer and other forms of the disease as well.

Earlier this year the Food and Drug Administration granted fast-track approval status for atezolizumab for the treatment of bladder cancer treatment, and, this past April, added lung cancer as well.

According to Balar, there are two major types of bladder cancer. The most common – and curable – type of bladder cancer occurs superficially on the organ, and can be successfully treated with a biological agent called Calmette-Guerin (BCG), with surgery also performed on people whose tumors appear aggressive.

But invasive bladder cancer, which accounts for 25 percent of cases, is different – and far more deadly. 

“With invasive bladder cancer, you may look at a scan and see cancer is only in the bladder and not anywhere else in the body. But by that time, there probably is cancer elsewhere in the body as well,” says Balar. 

Once the cancer is found at that stage, the only standard treatment option is powerful chemotherapy with extremely toxic platinum-based agents. 

“Only about 50 percent of patients are fit enough to even receive the treatment and for those who do, the cancer eventually comes back,” notes Balar. 

Immunotherapy, though, is different.  These drugs act to perk up the body’s natural defenses – the immune system – to target and destroy the tumors without harming healthy tissues. This makes side effects far less serious, notes Balar.

“With chemotherapy, patients were in pain and they felt all sorts of symptoms. Now, with immunotherapy, they tell me the pain is disappearing, and that’s extremely rewarding,” he says. “I’m seeing patients come back to life before my eyes."

Pagano refers to immunotherapy as “the easiest” of the treatments he underwent. “But here’s the really good news,” he adds.“ The eight tumors are gone, my liver is clear, my spine is clear, and my lymph nodes have stopped lighting up (on imaging tests).”

And, although the tumor in his pelvis is still there, it is smaller.

“Immunotherapy is working. It’s keeping me alive, and I’m grateful that it’s around,” he says.

May is bladder cancer awareness month. Here is what you need to know:

• Bladder cancer is the fifth most common cancer in the U.S.
• Each year, about 73,000 people, mostly men, are diagnosed with bladder cancer. (55,000 men compared to 18,000 women).  The average age at diagnosis is 73.
• About 16,000 people die from bladder cancer each year.
• The overall cure rate of bladder cancer is 77 percent, but this drops to 34 percent for patients in which the disease has spread outside the bladder, and to five percent for those where it has spread to distant organs, like the liver.
• It isn’t known what causes bladder cancer, but major risk factors include smoking, chemical exposure and parasitic infection.
• The most common symptom is blood in the urine, frequent urinary tract infections, and pain upon urinating.
• Bladder cancer has been linked to U.S. Veterans that were exposed to Agent Orange in Vietnam. Veterans diagnosed with bladder cancer should qualify for compensation and special access to medical care. You do not need to prove that Agent Orange caused your cancer.