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BackTable / Urology / Topic / Condition

Bladder Cancer

Bladder cancer is the ninth most common cancer in the world and is the most common malignant neoplasm in the urinary system. This condition occurs in older individuals, with the majority of patients being older than 65 years of age. Around 90% of bladder cancers are transitional cell carcinoma, and most other cases are squamous cell carcinoma of the bladder, which is associated with chronic bladder irritation. Only 1% of bladder cancers are primary adenocarcinoma, and these cases generally occur in patients with a history of bladder exstrophy or uracheal adenocarcinoma. Chemical carcinogenesis is associated with an increased risk for bladder cancer, with cigarette smoke being one of the most strongly associated factors. Other risk factors include chronic cystitis, Human Papillomavirus infection, upper urinary tract cancer, and bladder augmentation.

Bladder Cancer Condition Overview

Learn more on the BackTable Urology Podcast

BackTable is a knowledge resource for physicians by physicians. Get practical advice on Bladder Cancer and how to build your practice by listening to the BackTable Urology Podcast, reading exclusing BackTable Articles, and following the work of our Contributors.

Ep 172 Advancing Cancer Care: AUA 2024 Highlights in Prostate & Bladder Cancer with Dr. Jeff Tosoian and Dr. Woodson Smelser
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Bladder Cancer Diagnosis

Symptoms of bladder cancer include gross or microscopic hematuria, urinary frequency, urgency dysuria, and ureteral obstruction. Diagnosis of bladder cancer may be delayed due to the number of shared symptoms with other disorders, such as urinary tract infection, cystitis, and prostatitis. This often leads to diagnosis at an advanced stage of the disease. A full urologic evaluation should be done for patients experiencing hematuria. This involves a complete history and physical exam, and in some cases a urine sample, cystoscopy, or intravenous pyelography. After a diagnosis, additional studies, including liver function test, chest x-rays, and blood count should be performed. CT scans for the bladder are helpful in examining the bladder wall thickening and lymph node involvement.

Bladder Cancer Podcasts

Listen to leading physicians discuss bladder cancer on the BackTable Urology Podcast. Get tips, tricks, and expert guidance from your peers and level up your practice.

Episode #193

Urology

Catch up on the latest breakthroughs in bladder cancer management. In this episode of the BackTable Urology Podcast, Dr. Bogdana Schmidt (University of Utah) speaks with Dr. Andrea Apolo, a medical oncologist at the National Cancer Institute, about recent advancements in bladder cancer treatment presented at the 2024 European Society of Medical Oncology (ESMO) Congress.

Episode #186

Urology

What is the role of blue light cystoscopy in bladder cancer? In this episode, Dr. Suzette Sutherland interviews Dr. Suzanne Merrill from Colorado Urology about the benefits of this technology in the diagnosis and treatment of bladder cancer, and how to implement it into your practice.

Episode #178

Urology

Stay up-to-date on the latest advancements and treatment strategies in the field of genitourinary oncology. In this episode of BackTable Urology, guest host Dr. Bogdana Schmidt, a urologic oncologist from the University of Utah, discusses takeaways from ASCO 2024 with Dr. Petros Grivas from Fred Hutchinson Cancer Center and Dr. Sumanta (Monty) Pal from City of Hope.

Episode #177

Urology

Dr. Ashish Kamat discusses contemporary management of high-risk, non-muscle-invasive bladder cancer (NMIBC) and his thoughts into the future of this arena.

Episode #172

Urology

In this episode of the BackTable Urology, Dr. Bogdana Schmidt (University of Utah), Dr. Woodson Smelser (Washington University in St. Louis), and Dr. Jeff Tosoian (Vanderbilt University) discusses the latest insights and advancements in prostate and bladder cancer treatment presented at AUA 2024.

Episode #161

Urology

This week on BackTable Urology, Dr. Suzette Sutherland (University of Washington) and Dr. Drew Peterson (Duke University) explore the psychological and clinical challenges faced by genitourinary cancer survivors dealing with the urological consequences of cystectomy and urinary diversion.

Episode #160

Urology

This week on BackTable Urology, Dr. Seth Lerner (Baylor College of Medicine) discusses the intricacies of lymph node dissection in bladder cancer management, including an overview of patterns of metastasis, genomic classifiers, and recent clinical trials.

Episode #157

Urology

In this special crossover episode with the Bladder Cancer Matters podcasts, Rick Bangs, a bladder cancer survivor, and Dr. Aditya Bagrodia, a urologic oncologist, discuss shared decision-making in bladder cancer treatment.

Episode #149

Urology

This week on BackTable Urology, urologic oncologist Dr. Bogdana Schmidt (University of Utah) hosts a discussion with medical oncology experts Dr. Rana McKay (UC San Diego) and Dr. Neeraj Agarwal (University of Utah) on recent clinical trials from bladder, kidney, and prostate cancer research presented at the 2023 European Society for Medical Oncology (ESMO) Meeting.

Episode #139

Urology

In this week’s BackTable Podcast, guests Dr. Sarah Psutka and Dr. Rachel Rubin join host Dr. Aditya Bagrodia to discuss the importance of considering women’s sexual health in urologic oncology surgeries.

Episode #103

Urology

In this episode of BackTable Urology, Dr. Aditya Bagrodia invites Dr. Yair Lotan, professor of urologic oncology at UT Southwestern, and oncologist Dr. Suzanne Cole to discuss types of adjuvant treatment for high risk bladder cancer, including chemotherapy, radiation therapy, and immunotherapy.

Episode #64

Urology

In this episode of BackTable Urology, Dr. Aditya Bagrodia speaks with two fellow urologic oncologists, Dr. Timothy Clinton (Brigham and Women’s Hospital) and Dr. Eugene Pietzak (Memorial Sloan Kettering), about the management of BCG-refractory non muscle-invasive bladder cancer.

Episode #57

Urology

In this episode of BackTable Urology, Dr. Aditya Bagrodia speaks with urologist Dr. Anne Schuckman from the University of Southern California about advantages and advice for blue light cystoscopy, a procedure performed to identify bladder tumors during transurethral resection of bladder tumor (TURBT).

Episode #54

Urology

In this episode of BackTable Urology, Dr. Aditya Bagrodia discusses methods and benefits of smoking cessation in urologic oncology patients with Dr. Christian Fankhauser from Luzerner Kantonsspital and Dr. Richard Matulewicz from Memorial Sloan Kettering.

Episode #46

Urology

In this episode of BackTable Urology, Dr. Aditya Bagrodia interviews Dr. Sam Chang, chief of urologic oncology at Vanderbilt University, about surgical tips and tricks for intermediate and high risk bladder cancer.

Episode #25

Urology

We talk with Dr. Siamak Daneshmand, Director of Urologic Oncology at USC Institute Of Urology, about the management of muscle-invasive bladder cancer. Listen to the full episode to learn tips for successful transurethral resections of bladder tumor (TURBT) and cystectomies, using imaging to stage bladder cancers, deciding between a cystectomy vs. trimodality therapy (TMT), and comparisons between neobladder procedures and urinary diversions.

Episode #18

Urology

We finish our discussion with Dr. Angie Smith from University of North Carolina at Chapel Hill about peri-operative optimization of radical cystectomies. She discusses pre-operative incentive spirometry, opioid and NSAID regimens, post-operative drains and stents, and the importance of multidisciplinary collaboration.

Episode #17

Urology

We talk with Dr. Angie Smith about perioperative measures to optimize radical cystectomies.

Episode #2

Urology

Dr. Jose Silva talks with Urologist Dr. Aditya Bagrodia from UT Southwestern Medical Center about the medical and surgical management of bladder cancer.

Bladder Cancer Treatment

The preferred initial therapy for patients with metastatic bladder cancer is a cisplatin based combination chemotherapy. Candidates for this therapy must be evaluated for their ability to tolerate this chemotherapy. Renal function, peripheral neuropathy, hearing abilities, organ function, and comorbidities should be assessed. Patients who are not eligible for cisplatin based combination chemotherapy may be treated with carboplatin based regimens, non-platinum regimens, systemic immunotherapy, or single agent chemotherapy. Patients that have had a partial response to systemic therapies would be good candidates for transurethral resections of metastases or in severe cases, radical cystectomy with urinary diversion. Maintenance therapies, such as avelumab, are used in patients with advanced bladder cancer who did not respond to platinum based chemotherapy. Immunotherapies are used as a second line of treatment, and later line therapies are targeted at tumor alterations and patient preferences.

Bladder Cancer Articles

Read our exclusive BackTable Urology Articles for quick insights on bladder cancer, provided by physicians for physicians.

Blue Light vs White Light Cystoscopy in Bladder Cancer

Research now shows that using blue light and white light cystoscopy together maximizes bladder cancer detection while reducing unnecessary resections. Learn when to use blue light vs white light cystoscopy, and why using both together optimizes bladder cancer outcomes.

Blue Light Cystoscopy in Bladder Cancer: A Research-Based Perspective

Research now shows that incorporating blue light cystoscopy into bladder cancer detection and treatment significantly improves patient outcomes. Dr. Suzanne Merrill and Dr. Suzette Sutherland review the data and the guidelines around blue light cystoscopy in bladder cancer.

Histology of high grade bladder cancer

The management of high-grade BCG-unresponsive bladder cancer begins with the establishment of cytology and, based on the patient profile, is followed by either TURBT or total cystectomy. Alternatives to BCG for bladder cancer are available, but ongoing research continues to explore other options.

Cystoscopic Image of Bladder cancer

BCG-unresponsive bladder cancer has distinct criteria for diagnosis and management. Official FDA diagnosis requires the development or recurrence of a high-grade bladder tumor after a patient has received adequate BCG therapy. Treatment duration varies based on whether an induction or maintenance course is indicated.

Doctor holding cystoscope for TURBT procedure

The TURBT procedure for bladder cancer is a common procedure. Urologist Dr. Chang shares his approach to successful bladder cancer resection with TURBT, covering his technique before, during, & after.

Blue light cystoscopy screening for bladder cancer recurrence

Blue light cystoscopy is useful in managing bladder cancer, both for complete tumor resection in the OR and as routine surveillance office cystoscopy to monitor bladder cancer recurrence.

References

[1] Metts, M C, et al. “Bladder Cancer: A Review of Diagnosis and Management.” Journal of the National Medical Association, National Medical Association, June 2000, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2640522/

Disclaimer: The Materials available on https://www.BackTable.com/ are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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Podcasts

Bladder Cancer Innovations: ESMO 2024 Highlights with Dr. Andrea Apolo on the BackTable Urology Podcast)
Blue Light Cystoscopy: Improving Bladder Cancer Detection with Dr. Suzanne Merrill on the BackTable Urology Podcast)
ASCO 2024: Game-Changing GU Oncology Updates in Bladder & Kidney Cancers with Dr. Sumanta Pal and Dr. Petros Grivas on the BackTable Urology Podcast)
Latest Approaches to Treat High-Risk NMIBC with Dr. Ashish Kamat on the BackTable Urology Podcast)
Advancing Cancer Care: AUA 2024 Highlights in Prostate & Bladder Cancer with Dr. Jeff Tosoian and Dr. Woodson Smelser on the BackTable Urology Podcast)
Perfecting Rectal Spacer Placement for Optimal Care with Dr. Neil Taunk on the BackTable Urology Podcast)

Articles

Blue Light vs White Light Cystoscopy in Bladder Cancer

Blue Light vs White Light Cystoscopy in Bladder Cancer

Blue Light Cystoscopy in Bladder Cancer: A Research-Based Perspective

Blue Light Cystoscopy in Bladder Cancer: A Research-Based Perspective

Histology of high grade bladder cancer

High-Grade BCG-Unresponsive Bladder Cancer Management & Alternatives

Contributors

Dr. Neeraj Agarwal on the BackTable Urology Podcast

Dr. Neeraj Agarwal

Dr. Andrea Apolo on the BackTable Urology Podcast

Dr. Andrea Apolo

Dr. Aditya Bagrodia on the BackTable Urology Podcast

Dr. Aditya Bagrodia

Dr. Sam Chang on the BackTable Urology Podcast

Dr. Sam Chang

Dr. Timothy Clinton on the BackTable Urology Podcast

Dr. Timothy Clinton

Dr. Suzanne Cole on the BackTable Urology Podcast

Dr. Suzanne Cole

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