Navigation Links
Bladder cancer patients rarely receive recommended care
Date:7/10/2011

A new study has found that almost all patients with high-grade noninvasive bladder cancer do not receive complete care as recommended by current guidelines. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the study indicates that efforts are needed to identify and overcome barriers to providing optimal care to patients with bladder cancer.

High-grade noninvasive bladder cancer has up to a 70 percent chance of recurring after treatment and up to a 50 percent chance of progressing to a more invasive tumor. Effective treatment for patients with high-grade noninvasive bladder cancer is critical. If the bladder tumor recurs and remains noninvasive, patients must undergo multiple operations; if it recurs and progresses to an invasive cancer, patients are at risk of having the cancer spread, and they may need to have their bladder removed and undergo radiation and chemotherapy treatments.

Medical guidelines advocate for delivering anticancer chemotherapy directly into the bladder (intravesical therapy) in order to minimize recurrence and progression of bladder cancer. They also recommend an intense follow-up schedule involving the use of a scope to evaluate the bladder (cytoscopy) and a urine test (cytology) every three months. To see whether patients are actually receiving this recommended care, Karim Chamie, MD, MSHS of the University of California Los Angeles led a team of researchers from UCLA's Jonsson Comprehensive Cancer Center that analyzed information on 4,545 patients diagnosed with high-grade noninvasive bladder cancer from 1992 to 2002 whose data were contained in the Surveillance, Epidemiology and End Results (SEER)-Medicare database, which links cancer registry information to a master file of Medicare enrollment. "To our surprise, out of the 4,545 patients, only one received care that was compliant with all the guideline recommendations," said Dr. Chamie. "In addition, nearly half of urologists have not performed at least one cystoscopy, one cytology, and one instillation of intravesical therapy for any given patient in the first two years after diagnosis."

The researchers measured whether patients' age, race, socioeconomic status, severity of other medical conditions, and extent of their bladder cancer contributed to the low compliance rate with guideline recommendations. They discovered that these patient-level factors had little effect. Rather, the most important predictor of whether a patient underwent recommended care was the physician. Additional studies are needed to identify why the vast majority of physicians are not following medical guidelines related to bladder cancer.

Based on these findings, "one would deduce that more than 99 percent of patients with high-risk bladder cancer are not receiving recommended care. This is significantly less than what most patients with bladder cancer, their physicians, and policy makers believe is happening," said Dr. Chamie. "We hope that shedding light on the level of discordance between ideal and routine care will prompt policy makers to modify reimbursement policies or support quality-improvement initiatives in the future."


'/>"/>

Contact: Jennifer Beal
healthnews@wiley.com
44-012-437-70633
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Costly tests may not help detect bladder cancer recurrence, M. D. Anderson study finds
2. San Francisco Firefighters: Increased Risk for Bladder Cancer – Testing Underway
3. Meat Lovers Face Greater Risk of Bladder Cancer
4. Unmet expectations and smoking prove key factors in quitting bladder medication
5. Clue to switch of bladder cancer from locally contained to invasive found by Jefferson scientists
6. Study finds 2 sling surgeries equally effective for bladder control in women
7. Vitamins Fail to Protect Men Against Bladder Cancer
8. Radiation does not improve survival for rare, invasive bladder cancer
9. Removing Gallbladder Sooner Cuts Costs, Readmissions
10. NOSCAR announces first NOTES transoral and transvaginal gallbladder removals performed as part of US multicenter human trial
11. Certain meat components may increase bladder cancer risk
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... (PRWEB) , ... October 13, 2017 , ... Many families ... However, many long-term care insurance companies have a waiver for care if the client ... elimination period, when the family pays for care, is often waived, so the benefits ...
(Date:10/13/2017)... ... October 13, 2017 , ... Yisrayl Hawkins, Pastor and Overseer ... one of the most popular and least understood books in the Holy Scriptures, Revelation. ... descriptions that have baffled scholars for centuries. Many have tossed it off as mere ...
(Date:10/13/2017)... ... ... “America On The Brink”: the Christian history of the United States and the ... published author, William Nowers. Captain Nowers and his wife, Millie, have six children, ... in the Navy. Following his career as a naval aviator and carrier pilot, ...
(Date:10/12/2017)... (PRWEB) , ... October 12, 2017 , ... ... products to meet the demand of today’s consumer and regulatory authorities worldwide. From ... probiotic experts and tested to meet the highest standard. , These products ...
(Date:10/12/2017)... , ... October 12, 2017 , ... ... delivery system that we intend to develop to enable prevention of a major ... to severe hearing loss, especially in pediatric patients. For cisplatin, hearing loss is ...
Breaking Medicine News(10 mins):
(Date:9/22/2017)... 22, 2017  As the latest Obamacare repeal effort ... Cassidy (R-LA) and Lindsey Graham (R-SC) ... medical device industry is in an odd place.  The ... 2.3% excise tax on medical device sales passed along ... covered patients, increased visits and hospital customers with the ...
(Date:9/19/2017)... ZirMed Inc ., a recognized leader in cloud-based revenue cycle ... ranked #1 by its users for the seventh consecutive year ... ZirMed was recognized as the top-ranked end-to-end revenue cycle management ... 200 beds and holds one of the longest #1 ranking ... ...
(Date:9/13/2017)... 13, 2017   OrthoAtlanta has been named the ... Host Committee (AFHC) for the 2018 College Football Playoff (CFP) ... at Mercedes-Benz Stadium in Atlanta, Georgia . ... "I,m In" campaign, participating in many activities leading up to, ... ...
Breaking Medicine Technology: