Bladder Cancer Awareness Month: an opportunity for collaborative action to address pressing patient needs (Guest blog)
A guest blog by Dr Ignacio Durán, Medical Oncologist at the Marques de Valdecilla University Hospital and IDIVAL in Santander, Spain
Each year, Bladder Cancer Awareness Month (BCAM) is recognised in May, providing an important opportunity for the bladder cancer community to come together and shine a spotlight on this underrepresented disease.[1],[2]
Around 151,000 Europeans are diagnosed with bladder cancer every year, making it the fifth most frequent cancer diagnosis on the continent and the second most common urological cancer.[3],[4]
Yet, despite these figures, bladder cancer continues to be overlooked in terms of public awareness, funding and research,[2],[3] and patients are the first to feel the effects of this.Barriers to optimal management in bladder cancer
There are several key challenges that we must face before we can transform outcomes for bladder cancer patients. Firstly, an early diagnosis is vital for bladder cancer survival, because we know that 96% of patients survive beyond 5 years if diagnosed before the cancer spreads beyond the inner bladder wall.[5],[6]
We also see a gender disparity in bladder cancer; the disease is approximately four times more frequent in men than women, but women tend to be diagnosed later and with more advanced disease, facing a worse prognosis in terms of outcomes and survival rates than their male counterparts.[7]Whatever your gender, it’s important to be aware of earlier potential symptoms of bladder cancer, like blood in the urine (haematuria), and go and speak to a physician.[8],[9]
Another barrier to an early diagnosis, better outcomes and increased quality of life is stigma.[10] The perceived embarrassment of a urological disease in an intimate area not only has an impact on mental health but also prevents some from seeking medical help.[8],[11] All these factors can make bladder cancer an isolating disease[12] and reduce the chance of early intervention.
Every bladder cancer patient faces a different journey from their peers and has different needs.[13] As physicians, I think we do well in educating our patients about what bladder cancer is, but we need to make sure that we are involving patients in the decision-making process so that both physician and patient can make an informed decision, depending on where they are in their journey. This way, we can increase engagement and strive for outcomes that are truly meaningful for people with bladder cancer.
The impact of innovation in bladder cancer: bringing new hope to patients and their families
Just as every bladder cancer patient is unique, their treatment should also be specific to them.[13],[14]
Recent years have seen a greater focus on treatments targeting the genetic drivers of bladder cancer.[14] Changes in DNA repair signalling pathways show potential as predictors of chemotherapy response,[14] and biomarkers have led to advances in precision medicine, paving the way for novel and tailored therapeutic approaches for bladder cancer patients.[15] Moreover, new drugs with innovative mechanisms of action are being incorporated in to bladder cancer therapeutics and improving patient’s outcomes.[16]It’s these revolutionary developments in targeted innovation that give me real hope that we can move beyond the ‘one-size-fits-all’ treatment paradigm, adapting to the genetic makeup, lifestyle and environment of every patient. As our understanding of predictive biomarkers grows, we have the potential to change what a cancer diagnosis means for patients and their families, giving back time and quality of life to people living with the disease.[13]
References
[1] WBCPC World Bladder Cancer Awareness Month Toolkit 2020. Available at: https://worldbladdercancer.org/wp-content/uploads/2020/09/WBCAM2020_Toolkit_FINAL.pdf. Last accessed May 2022.
[2] Van Hemelrijc M. et al (2020) Editorial: Bladder Cancer – A Cinderella Cancer: Advances and Remaining Research Questions. Available at: https://doi.org/10.3389/fonc.2020.01749. Last accessed May 2022.
[3] European Cancer Patient Initiative. Urological cancer. Available at: https://ecpc.org/news-events/bladder-cancer/. Last accessed May 2022.
[4] IARC/WHO. Cancer Today, 2020. Estimated number of new cases in 2020, Europe, both sexes, all ages Available at: https://gco.iarc.fr/today/online-analysis-table?v=2020&mode=cancer&mode_population=continents&population=900&populations=908&key=asr&sex=0&cancer=39&type=0&statistic=5&prevalence=0&population_group=0&ages_group%5B%5D=0&ages_group%5B%5D=17&group_cancer=1&include_nmsc=1&include_nmsc_other=1 . Last Accessed May 2022
[5] Waldron, Nick et al, Current management of advanced bladder cancer. Available at: https://onlinelibrary.wiley.com/doi/pdf/10.1002/tre.603. Last accessed May 2022.
[6] National Cancer Institute. Cancer Stat Facts: Bladder Cancer. Available at: https://seer.cancer.gov/statfacts/html/urinb.html. Last accessed May 2022.
[7] Bladder Cancer Advocacy Network. Women and Bladder Cancer. 2022. Available at: https://bcan.org/women-bladder-cancer/. Last accessed May 2022.
[8] NHS. Symptoms of bladder cancer. Available at: https://www.nhs.uk/conditions/bladder-cancer/symptoms/. Last accessed May 2022.
[9] Fight Bladder Cancer. Raise awareness. Available at: https://www.fightbladdercancer.co.uk/get-involved/raise-awareness. Last accessed May 2022.
[10] Akin-Odanye E, O, et al. Impact of stigma and stigma-focused interventions on screening and treatment outcomes in cancer patients. Ecancermedicalscience. 2021;15:1308.
[11] Fight Bladder Cancer. Surviving bladder cancer. Available at: https://fightbladdercancer.co.uk/get-help/living-cancer/surviving-bladder-cancer. Last accessed May 2022.
[12] World Bladder Cancer Patient Coalition. Understanding bladder cancer patient experience - Bladder cancer patient and caregiver evidence generation study. Available at: https://worldbladdercancer.org/bladder-cancer-article/understanding-bladder-cancer-patient-experience/. Last accessed May 2022.
[13] The Pharmaceutical Journal. The precision medicine approach to cancer therapy: part 1 — solid tumours. Available at: https://pharmaceutical-journal.com/article/research/the-precision-medicine-approach-to-cancer-therapy-part-1-solid-tumours. Last accessed May 2022.
[14] Grunewald, C, M. et al. Personalisierte Medizin im Urothelkarzinom der Harnblase [Personalised medicine in urothelial bladder cancer]. Aktuelle Urol. 2019; 50(5):502-508. Available at: https://pubmed.ncbi.nlm.nih.gov/31195416/. Last accessed May 2022.
[15] Guercio, B, J. et al. Developing Precision Medicine for Bladder Cancer. Hematol Oncol Clin North Am. 2021;35(3):633-653.
[16] Bellmunt J et al Recent therapeutic advances in urothelial carcinoma: A paradigm shift in disease management. Crit Rev Oncol Hematol. 2022 Apr 16;174:103683. doi: 10.1016/j.critrevonc.2022.103683. Epub ahead of print. PMID: 35439541.
Job code: CP-315358
Date of preparation: May 2022