A Personalized Approach to Bladder Preservation in Urologic Cancers

Urologic cancer care is shifting towards a less invasive, personalized approache, according to Dr. Armine Smith. Smith shares how bladder preservation requires a careful, individualized approach — one that balances clinical criteria with patient-centered considerations. She touches on the complexity of treatment decisions and the importance of selecting the right candidates for this intensive path.

Smith is a Urologist at Johns Hopkins University, the director of urologic oncology at Sibley Memorial Hospital, and co-director for women's bladder cancer program at Johns Hopkins University and Greenberg Bladder Cancer Institute.

Transcript:

CURE: For patients newly diagnosed with bladder cancer, especially those considering bladder preservation, what are the key factors you weigh when determining if this approach is suitable, and how do you personalize that treatment plan?

So, when considering bladder preservation, we'll look at the standard information that comes with it, like bladder tumor grade stage. There are some other additional factors that may make the patient more suitable or not for bladder preservation. [These factors include] if there are multifocal tumors, if there are any advanced stage that's present, if the tumor is unresectable, as well as [the] urological subtypes of these bladder cancers.

Those are all the important pieces of information we consider. To preserve the bladder, we need to have a functioning bladder that will give the patient good quality of life afterwards. Some other factors to consider. This is a pretty complex process. Some of the factors are just patients’ overall morbidities, you know, their health, their ability to adhere to these very stringent surveillance protocols [and] the ability to undergo these treatments.

So currently, the bladder preservation includes treatments with chemotherapy, or immunotherapy with radiation to the bladder, and resections of the bladder and the ability to continue the monitoring. All of this information comes together when we find the right personalized approach to every patient for this.

Transcript has been edited for clarity and conciseness.

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