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Bladder Cancer Patients Not Getting Recommended Care: Study
Date:7/12/2011

ttack the bladder cancer. Imaging of the upper urinary tract with a CT scan, MRI scan or renal ultrasound is also recommended at diagnosis and every two years thereafter.

This would mean each patient receiving eight cystoscopy exams, eight urine tests, two upper urinary tract imaging exams, one chemotherapy shot and six BCG treatments in the two years after their diagnosis, according to the report.

Compliance with the guidelines had little to do with the patients' age, race or economic status. Instead, it was about the doctors who were treating them, the researchers said. The guidelines may not be reaching the urologists at community hospitals, which is where the majority of people are treated, they concluded.

Full adherence to the recommendations "only happened for one person in the study," Chamie said.

When researchers relaxed the standard to one cystoscopy, one cytology and one injection of BCG during the two-year follow-up, 37 percent of patients received the recommended treatment, and just 58 percent of doctors followed these less-strict guidelines on any one patient within two years.

Ongoing research suggests that following these comprehensive care guidelines may confer a survival edge for people with bladder cancer, he said.

Dr. H. Barton Grossman, professor and deputy chairman of the urology department at M.D. Anderson Cancer Center in Houston, said the guidelines described in the new study "are arbitrary and set the bar too high so it looks like everyone failed."

That said, even when the study authors relaxed the standards, they still were not met, Grossman said.

The authors' suggestions for boosting compliance rates included modifying reimbursement rates and conducting additional research to identify barriers to comprehensive treatment.

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