A new study released this Monday by UCLA's Jonsson Comprehensive Cancer Center shows a large 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.
According to the Bladder Cancer Advocacy Network (BCAN) this is not surprising. The BCAN is the first national organization dedicated to advancing bladder cancer research and public awareness. Lawrence Rzepka, BCAN Executive Director said, “… we continue to be disappointed by the low quality of care and attention many bladder cancer patients are receiving.”
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 and National Comprehensive Cancer Network.
Dr. Badrinath Konety, BCAN Scientific Advisory Board member and co-author of the study said one of the reasons for this finding may be in 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,” he said.
Dr. 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. Dr. 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.
Gary Steinberg, BCAN Scientific Advisory Board chairperson and Chief of Urologic Oncology at the University of Chicago said, “Ultimately, we hope Dr. 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. 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.”
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