Current Landscape and Future Directions on Bladder Sparing Approaches to Muscle-Invasive Bladder Cancer - Beyond the Abstract

Bladder cancer is among the most common malignancies of the urinary tract. In the United States, muscle-invasive bladder cancer is typically treated with radical cystectomy plus perioperative chemotherapy. However, radical cystectomy is associated with considerable morbidity and impact on quality of life. Furthermore, bladder cancer is a disease of the elderly with a median age of 70 at the time of diagnosis. Smoking is a well-documented risk factor, and many patients have smoking-related co-morbidities such as chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD). Simply put, many bladder cancer patients are unfit for aggressive surgery and as a consequence are not offered curative-intent treatment.

Tri-modal therapy (TMT) is an under-utilized, organ-sparing alternative to cystectomy for some patients with muscle-invasive bladder cancer which offers outcomes comparable to surgery and relatively favorable long-term quality of life measures. Our article “Current Landscape and Future Directions on Bladder Sparing Approaches to Muscle-Invasive Bladder Cancer” summarizes the existing literature on TMT and provides insight into future directions. It is our hope that this article improves awareness of this valuable treatment modality and ultimately increases the likelihood of bladder cancer patients being offered curative-intent therapy.

Written by: James Broughman, MD, Winston Vuong, MD, Omar Mian, MD, PhD, Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio

Read the Abstract

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