Get the Facts About Bladder Cancer

Each May, the World Bladder Cancer Patient Coalition hosts Bladder Cancer Awareness Month to highlight the facts about bladder cancer, promote awareness about the disease, and call for more investment in research, treatment, and care. This year’s theme emphasizes the importance promoting conversations about bladder cancer and its symptoms, treatments, and management. Poor patient engagement can lead to poor adherence, poor symptom management, and disparities in outcomes among different groups.

Gender Differences

Historically viewed as a disease of older white men, the reality of bladder cancer is more nuanced. It is the 7th-most common cancer in the U.S., the 4th-most common cancer for men, and the 11th-most common cancer for women. The American Cancer Society projects that about 83,730 new cases of bladder cancer (approx. 64,280 in men and 19,450 in women) will be diagnosed in the U.S. in 2021. Overall, the chance a man will develop bladder cancer in his lifetime is about 1 in 27. For women, it is about 1 in 89. However, bladder cancer is more lethal in women than in men. Compared to men, women present with more advanced bladder cancer, have a greater risk of recurrence, and experience worse overall survival.

Racial Disparities

Like many cancers, the incidence and treatment of bladder cancer is marked by racial disparities. Although White patients have twice the incidence rate of bladder cancer as Black patients, the latter present with more advanced disease (higher grade and stage tumors), and have up to 10 percent worse disease-specific survival than White patients. Black patients are also less likely to receive aggressive treatment than White patients. While the overall 5-year survival rate for bladder cancer is 77 percent, it is 64 percent for Black patients.

Patient Education

Enhanced health literacy and improved patient/provider communication could do much to disrupt these disparities and enhance overall outcomes. Research has documented the unmet supportive care needs of patients with bladder cancer across all phases of the cancer care continuum. A 2019 survey of patients with bladder cancer in Canada reported high levels of need for information about medical treatment options, practical strategies for managing bladder cancer, and supportive care resources.

One recently developed resource that specifically targets the needs of patients with bladder cancer is the Bladder Cancer Basics Handbook from the Bladder Cancer Advocacy Network (BCAN). The handbook, available free of charge as a downloadable pdf, teaches patients about their diagnosis and treatment options to help them make informed decisions in collaboration with members of their care team. The handbook describes the types of tests used to diagnose bladder cancer, what it means to stage and grade the disease, the types of treatments prescribed (including recently approved immunotherapies), and additional patient resources. Also available from BCAN is Tips for Caregivers, a companion handbook for patient caregivers that includes helpful tools and resources to navigate the cancer care journey.

Multidisciplinary Care

Developing and employing effective patient education practices and resources is often the mark of a cohesive multidisciplinary cancer care team. Many cancer practices embrace the patient-centered multidisciplinary care approach, and research affirming its effectiveness is ever-growing.

Recently, a team of clinicians and social workers wrote about the success of a patient-centered, interdisciplinary collaborative model of care created for patients with bladder cancer. The Bladder Patient-Centered Interdisciplinary Team (BPIT) model emphasizes the patient as an active participant in treatment and a member of the care team, along with oncology nurses, wound ostomy and continence nurses, and oncology social workers. When members of the care team are able to efficiently and effectively communicate, consult, and generate discipline- and team-specific care plans, patients benefit.

ACCC’s Bladder Cancer Education Projects

ACCC’s education program, Optimizing Outcomes for Urothelial Carcinoma, is designed to give members of the multidisciplinary care team the knowledge they need to address the practical issues and barriers involved in integrating immunotherapy and other novel targeted therapies into the treatment of advanced urothelial carcinoma. An online CME-accredited course on the topic is aimed at helping community clinicians keep current with: evidence-based practice guidelines, the clinical efficacy of new therapies, how to monitor and manage adverse events, and how to engage patients to help them make informed treatment decisions.

Stay tuned for more tools for the cancer care team from ACCC in the upcoming project, Multidisciplinary Bladder Cancer Care, which will address barriers to engaging patients in treatment and surveillance, the impact of disparities in care, and the costs of delaying treatment due to constrained financial and clinical resources.