Quality of life considerations for patients with Muscle Invasive Bladder Cancer


Angela Smith gave an excellent review on quality of life in patients with bladder cancer. She recognizes that the majority of QOL literature retrospective, and often results are mixed.
One prospective QOL study from University of Chicago (n=73) used the FACT-VCI at baseline and 6 months after RC. No differences in overall survival or overall HRQOL but improved emotional HRQOL after cystectomy. The effect of diversion on body image may have an initial decrease, but improves over time. Many studies compare QOL between diversions, most show little differences between groups historically. However, recent meta-analysis favors neobladder in all domains(Ghosh & Somani, 2016). Although the quality of life literature is often difficult to collect level 1 evidence, Dr. Smith advocates for care and attention to this area. Reminds us that the emotional, body image and sexual declines are real, although can gain improvement over time.


Presented By: Angela Smith, MD, University of North Carolina, Chapel Hill and Kimberly Mak, MD, MPH, Moston Medical Center.

Written by: Michael J Metcalfe, MD. Fellow of Urologic Oncology Urology, MD Anderson Cancer Center, Houston TX. 

Ashish M. Kamat, MD, MBBS, FACS
President, International Bladder Cancer Network
Chair, Society of Immunotherapy for Cancer (SITC), BCTF
Director of Urologic Oncology Fellowship
Professor of Urology
Attending Surgeon, Division of Surgery
The University of Texas, MD Anderson Cancer Center

References:
Ghosh, A., & Somani, B. K. (2016). Recent Trends in Postcystectomy Health-related Quality of Life (QoL) Favors Neobladder Diversion: Systematic Review of the Literature. Urology, 93, 22-26. doi: 10.1016/j.urology.2015.12.079
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