Urologist

The Bladder Cancer Patient Journey

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

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

Bladder cancer occurs often

There are over 81,000 new cases of bladder cancer in the US and more than 17,000 deaths from the disease annually. Bladder cancer also has a high recurrence rate with an average of 61% in year one and 78% over five years, making the lifetime costs of managing bladder cancer one of the highest amongst all. Overall, bladder cancer is a costly, potentially progressive disease for which patients have to undergo multiple cystoscopies, due to the high risk of recurrence.

Learn more about the global bladder cancer challenge

Initial signs unclear but early detection critical

The first signs or symptoms of bladder cancer that a patient might typically notice may be visible blood or blood clots in their urine. Other common symptoms can include: pain during urination, frequently urinating in small amounts, or frequent urinary tract infections (UTIs).

The outlook for a patient diagnosed with cancer is fairly positive with high survival rates if it is detected and diagnosed early on, when there is the most chance of success in managing it successfully.

See bladder cancer survival rates by stage

Different types of bladder cancer

Once it is confirmed that the patient has bladder cancer, the question is how far the cancer has grown and spread.

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

NMIBC is when the cancer is still only in the inner layer of cells lining the bladder. These cancers are the most common - about 70% of all bladder cancer cases. Most patients survive this type of bladder cancer.

MIBC is when the cancer has grown into deeper layers 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 other parts of the body, it's called as advanced or metastatic bladder cancer.

Bladder cancer treatment options

Once the patient has been diagnosed with bladder cancer, the treatment team will discuss options. The treatment team could include several types of doctors, such as:

  • Urologists: surgeons who specialize in treating diseases of the urinary system and male reproductive system.
  • Radiation oncologists: doctors who treat cancer with radiation therapy.
  • Medical oncologists: doctors who treat cancer with medicines such as chemotherapy and immunotherapy.
  • Other specialists: such as physician assistants, nurse practitioners, nurses specialized in urology, nutrition specialists, social workers, and various health professionals.

For the patient, being diagnosed with any type of bladder cancer is stressful. It can be difficult for the patient, and those close to them, to understand what options may be best for them. Resources that can help them, such as information from patients' associations, are critical at this point.

Depending on the stage and grade of bladder cancer, the treatment team will present the patient with a summary of the most relevant treatment options, which could include:

Treatment for Non-Muscle Invasive Bladder Cancer

TURBT surgery to remove the cancer from the bladder (used in more than 90 % of patients) using a rigid (stiff) type of cystoscope.

Treatment for Muscle Invasive Bladder Cancer

  • Cystectomy surgery to remove the entire bladder.
  • Chemotherapy to destroy cancer cells using medicines (before or after surgery).
  • Immunotherapy inducing the body's natural defenses to attack bladder cancer cells.
  • Radiation therapy to destroy cancer cells using high-dose X-rays or other high-energy rays. (before or after surgery, or alongside chemotherapy).

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 can recur – and often does. The patient will need to return for frequent surveillance follow-ups over the years.

At each of these checks, any suspicious signs will often require a need to remove the tumors. The better the urologist's ability to detect any evidence of bladder cancer recurrence at an early stage and completely remove the cancerous cells: the better the chances for the patient's outcomes.

In the surveillance, flexible cystoscopes are used, typically with standard white light. Here, the addition of blue light cystoscopy with Hexvix/Cysview for better detection is an effective complement to the standard approach.

Learn more about blue light cystoscopy

Bladder cancer is expensive and resource-consuming

The earlier the cancer is diagnosed, ideally while it is still only within the lining of the bladder, the less resources the patient and the medical system will likely need to use on treating later-stage bladder cancer. Treating early stage (NMIBC) bladder cancer involves less impact on the patient, less change to their quality of life. For the medical system, it means shorter inpatient times, and less utilization of valuable medical facilities.

As a result, any method for improving the detection of bladder cancer occurrence – or recurrence - makes each patient's life easier - and allows the medical system to serve more patients with the resources.

Learn more about patients' bladder cancer treatment