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Tackling Cancer With Merck & Co., Inc. (MRK), Endo Health Solutions Inc (ENDP) & More: Bladder Cancer’s Biggest Current and Upcoming Players

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As I noted six weeks ago, cancer statistics are both staggering and disappointing. Although cancer deaths per 100,000 people have been on the downswing since 1991 thanks to access to more effective medications and better awareness about the negative health effects of smoking, there is still a lot of research and progress yet to achieve. My focus in this 12-week series is to bring to light both the need for continued research in these fields, as well as highlight ways you can profit from the biggest current and upcoming players in each area.

Merck & Co., Inc. (NYSE:MRK)

Over the past five weeks, we’ve looked at the four cancer types most expected to be diagnosed this year:

Today, we’ll turn our attention to the projected sixth-most diagnosed cancer: bladder cancer.

The skinny on bladder cancer
Bladder cancer is forecast to be diagnosed in 72,570 people this year, leading to an estimated 15,210 deaths. While the death toll isn’t anywhere near the totals we saw for lung cancer, it’s still much higher than the projected toll taken by melanoma.

In particular, bladder cancer tends to strike men with roughly four times greater frequency than women. It’s a particularly scary cancer because it rarely precludes many warning signs — outside of blood in the urine or potential irritation and the need to go to the bathroom more often — and there isn’t any tried-and-true simple diagnostic test to diagnose bladder cancer beyond obtaining cells from inside the bladder once a cause for concern exists.

Roughly half of all cases of bladder cancer are diagnosed when the cancer is in a non-invasive state. If caught early, survival rates are very high, with in-situ cases demonstrating 96% five-year survival rates. Once regional or distant, however, and the survival rates shoot down rapidly. The five-year survival for regional and distant cancer drop to just 33% and 6%, respectively, according to the American Cancer Society (link opens PDF).

Since 1975-1977, just as we’ve seen in previous cancer types, there have been improvements in the overall five-year survival rate, which has jumped from 73% to 80% in 2005-2009, but the biggest improvement has been a reduction in smoking — the primary risk factor for being diagnosed with bladder cancer — through better awareness campaigns of its dangers, and not through major treatment advances. In fact, bladder cancer diagnoses haven’t seen the same downtrend we’ve witnessed in numerous other cancer types.


Source: Surveillance, Epidemiology, and End Results Program & National Center for Health Statistics.

The typical treatment plan for bladder cancer entails surgery and/or chemotherapy and radiation after surgery in nearly all cases. Some earlier stage cases can be dealt with through immunotherapy and chemotherapy, while a combination of chemotherapy and/or radiation, as well as complete removal of the bladder can be used in more advanced cases.

Where investment dollars are headed
For lack of a better word, treatment options in bladder cancer are somewhat limiting. The same global chemotherapy treatments you often see employed in regional and advanced stages of many cancers are typically a patient’s “best shot.” Here’s a glimpse at some of the most common bladder cancer treatments.

BCG vaccine: In early stages of the disease, a toned down bacterium known as bacillus Calmette-Guerin, or BCG, can be injected directly into a patient’s bladder in order to stimulate their own immune system to recognize and fight cancer cells. The body’s immune system won’t be able to recognize cancer cells that have escaped the bladder wall, so this is definitely an early-stage vaccine designed to slow or halt disease progression. Both Sanofi SA (ADR) (NYSE:SNY) and Merck & Co., Inc. (NYSE:MRK) manufacture the BCG vaccine — which is more commonly used around the world as a tuberculosis vaccine, but has multiple other uses, including as an immunotherapy treatment for bladder cancer.

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