Navigation Links
Bladder cancer patients rarely receive recommended care

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

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:
(Date:11/25/2015)... ... November 25, 2015 , ... "When ... that regular bras were incredibly uncomfortable," said an inventor from Bronx, N.Y. "In ... She developed the patent-pending RECOVERY BRA for added comfort and support. The bra ...
(Date:11/25/2015)... ... November 25, 2015 , ... Many people know of ... weight gain, cold hands, and dry skin. But many people who find their cholesterol ... exercise regimen instead of their thyroid, especially if they don’t have any of the ...
(Date:11/25/2015)... ... November 25, 2015 , ... Students and parents have something to be thankful ... Create Real Impact awards. California Casualty is proud to support the contest ... distracted and reckless driving, the number one killer of young drivers. , Almost ...
(Date:11/24/2015)... ... November 24, 2015 , ... Eric C. Seidel, DMD and ... of the revolutionary BIOLASE WaterLase iPlus 2.0™ system. This advanced laser technology uses ... a dentist in Gettysburg, PA . From routine visits to cosmetic treatments, ...
(Date:11/24/2015)... ... November 24, 2015 , ... Young patients with a wide variety of ... and Dr. Kedar S. Lele, who are pediatric dentists in Tucson, AZ . ... WaterLase iPlus 2.0™ system causes minimal discomfort and bleeding to the patient during treatment ...
Breaking Medicine News(10 mins):
(Date:11/25/2015)... issue of United States patent No. 9,192,509  entitled: " Methods and Apparatus ... AVACEN 100 dry heat therapy medical device and specific methods of use, referred to by the ... - ... ... ...
(Date:11/25/2015)... Israel , November 25, 2015 ... "New Investors"), pursuant to which BioLight and the New ... IOPtima Ltd. subsidiary ("IOPtima") via a private placement. The ... of its innovative IOPtimate™ system used in the treatment ... approval pathway process for the IOPtimate™ system with the ...
(Date:11/25/2015)... November 25, 2015 --> ... sie eine Lizenz für das Patent über eine neue ... und ENS-Lyon innehaben, an Enyo Pharma vergeben haben. ... ins Leben gerufenen und von Edelris gemeinsam mit seinen ... ein Behandlungsziel für HBV identifiziert, und es wurden neue ...
Breaking Medicine Technology: