(Originally shared at the Oct. 2005 SUNA Annual meeting)

This update provides resources and ideas use within your organization. The bladder cancer education outreach programs at Western Urologic Associates in Colorado are explained by Martha Ruschival, RN.

NEWS BRIEF: According to the National Cancer Institute, the prevalence of bladder cancer in the U.S. has surpassed that of lung cancer. This cancer is linked to smoking and occupational exposure to chemicals, yet if detected early, this cancer is very treatable.

As reported in the USA Weekend Magazine, Sept. 16-18 by Peggy J. Noonan, Health Briefs for Everyone, Bladder Cancer: New Tool for Early Detection - 'This Year 13,000 Americans will die from bladder cancer, our fifth-most-common cancer. But if it's caught early -- before it becomes invasive -- the five-year survival rate is 95%. No single test gives 100% accurate results, so doctors use a combination of methods to test for bladder cancer. A study in the Journal of the American Medical Association reports that a simple, non-invasive, in-office urine test to detect a tumor marker called NMP22 was more than three times as accurate as conventional lab tests. Conventional testing caught only 16% of confirmed bladder cancers; the new test identified 55%."

Help educate your patients-- know the risk factors for bladder cancer:

• Smoking
• Exposure to smoke and carcinogens
• Occupational exposure to chemicals and dyes
• Family history

An important symptom of bladder cancer is blood in the urine (called hematuria), as well as, urinary burning and frequency. These symptoms should not be ignored. Between 20 and 25 percent of bladder cancers are first diagnosed after they have reached the invasive stage, making them much harder to treat successfully.

Bladder cancer facts:

• Bladder cancer is most common in men over 65 years.
• It is the 2nd most common urologic malignancy.
• It is the 5th most common cancer in the United States with more than 63,000 new cases per year, and 13,000 deaths annually.
• Men have 4 times higher incidence of bladder cancer than women, and it is the 4th most common cancer in men.
• Women have a higher mortality rate because they are generally diagnosed in later stages of the disease.
• Firefighters are particularly at risk, with a 2 times greater incidence than the general population.
• Bladder cancer has the highest rate of recurrence of any cancer, including skin cancer, with a 50-85 percent recurrence within 6-12 months.

Additional Resources for patients, family members and caregivers:
www.blcwebcafe.org, www.bcan.org, www.cancer.org, www.matritech.com

Bladder Cancer Education Outreach: Western Urologic Associates, Wheat Ridge, Colorado, implements a model for support groups, public cancer education forums and bladder cancer screening.

Nationwide there are few models for bladder cancer support groups and fewer examples of bladder cancer screenings. Western Urologic Associates, located in the Denver metro area, has been implementing a three-pronged approach to bladder cancer awareness and outreach for the past five years. This group has initiated support groups, screenings, and public cancer forums.

Under the coordination of Martha Ruschival, RN, a monthly bladder cancer support group has been meeting for the past five years and has a typical attendance of 40 plus members. "We provide speakers and support information for individuals with all stages of bladder cancer. Bladder cancer can be a chronic disease and by addressing both extremes of the disease process, it helps put things in perspective for the participants."

Western Urologic creates model for bladder cancer outreach

The stated purpose of the support group is to:

1. Provide support to bladder cancer patients, survivors, family, friends, interested members of the public, and healthcare professionals.
2. Provide education about all stages of the disease.
3. Provide updates on available treatment

Monthly one-hour support group meetings feature a local urologist, medical oncologist or radiation oncologist who addresses a bladder cancer topic or open group discussions facilitated by a WUA nurse. Time is reserved for questions and sharing among support group members.

Here are a few tips from Martha Ruschival, RN to get a support group started in your community:

1. Assess the need for such a group. "There is a need!" Develop specific target populations (patients, families, and/or healthcare providers).
2. Develop goals of the group "educational/support/a combination." This drives the format and speakers.
3. Present the idea to your urology or oncology group practice. "They provide both speaker/liaison needs and provide the patient population base you are trying to reach." Physician referral to the group activities bolsters attendance.
4. Ask the affiliated medical center for meeting space and communications support (hospital newsletters, hospital staff/patient contact).
5. Send reminder notices, post flyers, and add reminders to patient communication (billing or test result notifications) of the schedule of meeting dates.
6. Cross promote through the medical center communications department and submit a news release to the local media attn: community news and activities.
7. Recognize that the survivors and patients with metastatic disease versus invasive disease versus superficial bladder cancer will have different questions and interests. Provide a resource file of health updates and articles.
8. Provide other health outreach activities such as an annual cancer and nutrition forum, grand rounds sponsored presentations or health screenings, and cross promote the bladder cancer support groups.

Health Screening implemented for bladder cancer

At a September Men's Health Screening, sponsored by Western Urologic Associates and Exempla Lutheran Medical Center, more than 250 men qualified for a variety of health screenings during the three-hour event : Prostate cancer /PSA testing, testicular cancer screening, bladder cancer diagnosis using the NMP22® BladderChek® test, osteoporosis testing using heel scans, cholesterol and glucose testing, vision testing, fitness evaluations, and sleep apnea assessments. Smoking cessation and nutrition information were also available. The screening was free, but pre-registration was required.

The NMP22® BladderChek® test was utilized to screen more than 126 pre-qualified men attending the men's health screening. After undertaking a thorough search of bladder cancer screenings, Western Urologic Associates decided to use history of hematuria as the primary pre-qualification for the bladder cancer screening. Although smoking and occupational exposure to chemicals are risk factors, this information was collected but not utilized exclusively for directing men to the bladder cancer screening.

Bladder Health Awareness Week

From Nov. 14-19, Western Urologic Associates supported National Bladder Health Awareness Week by offering a public bladder cancer forum. It was held Nov. 19 and well attended. This group has been implementing activities for several years. "It helps identify with diseases that are rarely written or talked about," said Ruschival. "As a urology group, we are dedicated to education outreach. If we don't take the initiative to create awareness of bladder issues, who will?"

For additional information, contact Martha Ruschival at Western Urologic Associates, email This email address is being protected from spam bots, you need Javascript enabled to view it This educational update is a service of Matritech, makers of the NMP22® BladderChek® Test for the diagnosis and monitoring of bladder cancer. For more information on bladder cancer awareness, go to www.matritech.com. Bladder cancer awareness materials can be downloaded from this site.