The World Bladder Cancer Patient Coalition hosts this special month to highlight the facts about bladder cancer, promote awareness of the disease and call for more investment in research, treatment and care.
The theme of this year’s edition “Don’t Go Red. Go To A Doctor” is to highlight the fact that blood in the urine is the most common symptom of bladder cancer [1]. More info here.
It is important to recognize and act on any symptoms, such as blood in urine, as soon as possible, because the prognosis for bladder cancer is favourable when the disease is detected early (i.e. when the disease is not yet muscle invasive). Despite the good prognosis, many patients with non-muscle-invasive bladder cancer (NMIBC) have recurrent disease following initial treatment. Recurrent NMIBC is typically not life-threatening, but here too early detection is important for a good prognosis. That is why surveillance of NMIBC is so important.
– A few facts on NMIBC surveillance –
- NMIBC has a 31-78% probability of recurrence at 5 years [2]
- Surveillance in NMIBC is of utmost important to detect recurrences early [1]
- Standard follow-up includes regular cystoscopy, which is an invasive procedure that poses a significant burden for both patients and healthcare systems
- Bladder cancer is one of the most expensive cancer to treat, partly due to the high surveillance costs [3]
- Cystoscopy is an invasive procedure and can cause discomfort and anxiety in patients
Don’t worry too much, there is good news too!
– Urinary biomarkers for NMIBC surveillance –
The sensitivity of cystoscopy may be approached by 4 commercially available, non-invasive, urinary markers (Cxbladder Monitor, ADXBLADDER, Xpert Bladder Cancer Monitor and Bladder EpiCheck), as these tests have such high sensitivities and NPVs for high-grade disease [1]. For example, the Bladder EpiCheck® has a sensitivity of 91% and a NPV of 99% to detect high-grade bladder cancer [4]. Although RCTs are needed to draw firm conclusions, these promising results give us hope for a future in which the burden on patients and healthcare systems can be significantly reduced.
Regarding these 4 urinary biomarkers, the EAU guidelines recently included in their guidelines for the surveillance of low-/intermediate-risk NMIBC [1]:
These 4 tests might be used to replace and/or postpone cystoscopy as they may identify
the rare high-grade recurrences occurring in low/intermediate NMIBC [1].
This is a huge milestone for the surveillance of NMIBC and opens the door for the use of non-invasive urinary biomarkers in clinical practice!
– What can you do? –
You can actively support the Bladder Cancer Awareness Month campaign:
- Use these hashtags: #DontGoRed #BladderCancerMonth22
- Go to the awareness month page of the World Bladder Cancer Patient Coalition for more information
You can help raise awareness on all aspects of bladder cancer, including:
- The fact that blood in urine as the most common symptom
- The importance of early detection of bladder cancer during diagnosis and surveillance
- The high burden of cystoscopy during surveillance of NMIBC
- The promising road ahead with the use of non-invasive urinary markers for bladder cancer surveillance
References
- Babjuk M, Burger M, Compérat E, et al. European Association of Urology (EAU) guidelines on non-muscle-invasive bladder cancer (TaT1 and CIS). Update March 2022.
- Sylvester RJ, van der Meijden APM, Oosterlinck W et al. Eur Urol 2006;49:466-5.
- Aly A, Johnson C, Doleh Y, et al. J Clin Pathw 2020;6:51-60.
- Laukhtina E, Shim SR, Mori K et al. Eur Urol Oncol 2021;4:927-42. Corrigendum in Eur Urol Oncol 2022;doi: 10.1016/j.euo.2022.01.003.
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