According to a study released this week by UCLA’s Jonsson Comprehensive Cancer Center, the overwhelming majority of patients with high-grade non-muscle invasive bladder cancer do not receive the recommended treatment and surveillance, leaving them at higher risk for bladder cancer recurrence, progression, and death.

The Bladder Cancer Advocacy Network (BCAN), the first national organization dedicated to advancing bladder cancer research and public awareness, is not surprised by the study results, said Lawrence Rzepka, BCAN Executive Director. “However, we continue to be disappointed by the low quality of care and attention many bladder cancer patients are receiving.”

Aggressive disease
The UCLA study examined the records of more than 4,500 bladder cancer patients from across the country. These patients had high grade, relatively aggressive disease that had not invaded the muscle wall of the bladder. Of the patients studied, only 1 out of 4,500 received treatment that met all of the recommended guidelines for care as issued by the American Urological Association (AUA) and National Comprehensive Cancer Network (NCCN).

Lack of compliance
When asked why patients are not receiving vital treatment and surveillance, Badrinath Konety, M.D., FACS, MBA., BCAN Scientific Advisory Board member and co-author of the study, said that the problem lies with the doctors. “We found that the greatest cause of this lack of compliance is the doctors. Providers are failing to offer their bladder cancer patients the care that is proven to reduce mortality.”

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Data available for many years
This means that patient care could be improved by identifying why doctors are not giving bladder cancer patients the recommended treatment. Bernard Bochner, BCAN Scientific Advisory Board member and urologic surgeon at Memorial-Sloan Kettering Cancer Center, said that in some cases the guidelines are seen as controversial, and in other cases doctors may not be familiar with the current standards and guidelines of care. However, Bochner noted that the data supporting the need for some follow-up and treatment of patients with potentially aggressive non-muscle invasive tumors has been available for many years.

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Key treatment guidelines
Bochner is currently leading an effort sponsored by BCAN to study physicians as they treat patients with more advanced bladder cancer. His group will first determine whether doctors are complying with key treatment guidelines. When the recommended treatment is not provided, they will identify the reasons. This data will complement the results of the UCLA study, which found that physicians were not complying with care guidelines in early stage bladder cancer, but did not identify the reasons for the doctors’ lack of compliance.

Removing obstacles
“Ultimately, we hope Bochner and his colleagues will be able to determine why many doctors do not comply with current guidelines, and what can be done to remove the obstacles and ensure that doctors give all patients the appropriate care,” said Gary Steinberg, BCAN Scientific Advisory Board chairperson and Chief of Urologic Oncology at the University of Chicago. “Their work is an important piece of the collaborative research that has come out of BCAN’s annual Bladder Cancer Think Tank, which brings leading researchers from across the country together to advance bladder cancer research.”

Public awareness
The Bladder Cancer Advocacy Network was created in May 2005 as the first national non-profit organization for bladder cancer. BCAN’s mission is to increase public awareness about bladder cancer, advance bladder cancer research, and provide educational and support services for the bladder cancer community.

For more Information:
Bladder Cancer Advocacy Network (BCAN)

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