The Bladder Cancer Patient Journey

Patients must navigate a long process of diagnosis, treatment and follow-up.

Bladder cancer represents a significant burden for patients and the health care system. It is not only one of the most common cancers in men, but it also recurs frequently and requires intensive follow-up and surveillance over a long time. Options that can reduce the recurrence rate of bladder cancer would significantly reduce the patient's burden as well as the economic and social impacts of the disease.

Bladder cancer occurs frequently

Bladder cancer ranks as the seventh most common cancer worldwide with 1 720 000 prevalent cases (5-year prevalence rate), 573 000 new cases and more than 200 000 deaths annually in 2020.1
Approx. 75% of all bladder cancer cases occur in men.1 It has a high recurrence rate with an average of 61% in year one and 78% over five years.2 Bladder cancer has the highest lifetime treatment costs per patient of all cancers.3
Bladder cancer is a costly and burdensome disease for which patients have to undergo multiple cystoscopies and controls due to the high risk of recurrence and progression to a more advanced disease state. There is an urgent need to improve both the diagnosis and the management of bladder cancer for the benefit of patients and healthcare systems alike.

Learn more about the global bladder cancer challenge.

Initial signs unclear but early detection critical

The first signs or symptoms of bladder cancer is typically blood in the urine. Blood can occur both as visible blood or blood clots noticed by the patient, or only visible in a dip stick or microscopic examination. Other common symptoms can include: pain during urination, frequent urination, abdominal pain or frequent urinary tract infections (UTIs).

Watch the patient journey video.

Disease stage and –grade at time of diagnosis are important factors for the prognosis of bladder cancer. Early diagnosis of cancer and of cancer recurrence play a significant role in management and survival of the cancer.

Different types of bladder cancer

After the diagnosis of bladder cancer is confirmed, tissue analyses of the cancer and additional examinations like radiological imaging will be performed to assess the grade and stage of the disease.

Bladder cancer is classified into two types, non-muscle invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC).

NMIBC refers to the stage where the cancer is only confined to in the inner layer of cells lining the bladder. These cancers are the most common - about 75% of all bladder cancer cases.

MIBC refers to the stage where the cancer has grown into the musclelayers of the bladder wall. These cancers are less common than NMIBC but more likely to spread and harder to treat.

If bladder cancer has spread beyond the bladder itself, to adjacent organs or to other parts of the body, it is referred to as advanced or metastatic bladder cancer.

Bladder cancer treatment options

For a patient, being diagnosed with any type of cancer is stressful. It can be difficult both for the patient and for those close to them, to understand what options may be best for them. Seek advice from your health care provider and make sure you understand your situation and treatment options. As a patient, you should never be afraid to ask questions. Please note that additional resources might be available , such as information from patients' associations, which often can provide contact with other patients that are in or have been through the same situation.

The initial treatment for most bladder cancer is an endoscopic surgical procedure with removal of tumor tissue, referred to as transurethral resection of bladder tumor, TURBT. Frequently, the surgical procedure is followed by local chemo-or immunotherapy in the bladder. In some cases, removal of the entire bladder, cystectomy, will be necessary. Some patients will also be offered radiation therapy or systemic chemo- or immunotherapy.

Treatment decisions take time and consultation

Despite the urgency of a cancer diagnosis, patients will need to carefully consider the options presented to them, in consultation with their treatment team. Getting second opinions can be helpful, as well as seeking input from patients who have been through similar experiences.

The challenge of bladder cancer recurrence

Even after the first round of treatment, the journey is just beginning for the patients. Bladder cancer is a cancer with high chances of recurrence. The patient will need to return for frequent follow-ups over the years.

At each of these checks, any suspicious signs of cancer recurrence will require further assessment of and potentially removal of recurrent tumors. Early detection of cancer recurrence and optimal diagnosis and treatment are essential for better cancer control.

Bladder cancer is expensive and resource-consuming

Bladder cancer has the highest lifetime treatment costs per patient of all cancers.3

Bladder cancer is a costly, potentially progressive disease for which patients have to undergo multiple cystoscopies due to the high risk of recurrence. There is an urgent need to improve both the diagnosis and the management of bladder cancer for the benefit of patients and healthcare systems alike.

As a result, any method for improving the detection of bladder cancer occurrence – or recurrence – impact patients' lives – and allows the health care system to serve more patients with the resources.

Learn more about patients' bladder cancer treatment.

 

References:

1 Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, Znaor A, Soerjomataram I, Bray F (2018). Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer. Available from: https://gco.iarc.fr/today, accessed [April 2021]

2 Babjuk M, et al. Eur Urol. 2019; 76(5): 639-657

3 Sievert KD et al. World J Urol 2009;27:295–300)