Dr. James Ferguson on future research needs for muscle-invasive bladder cancer

Opinion
Video

“At this point, we really have to consider the hard work and next steps of setting up multi-institutional databases and registries aimed at drilling down on patient and provider factors and medical decision-making around this diagnosis,” says James Ferguson III, MD, PhD.

In this video, James Ferguson III, MD, PhD, discusses future potential research following the recent Urologic Oncology paper, “Analysis of treatment of muscle invasive bladder cancer using the national cancer database: Factors associated with receipt of aggressive therapy.” Ferguson is an assistant professor of urology at the University of Alabama at Birmingham.

Transcription:

Is further research on this topic planned? If so, what will it focus on?

I think we've exhausted what we can learn from administrative databases on the subject. At this point, we really have to consider the hard work and next steps of setting up multi-institutional databases and registries aimed at drilling down on patient and provider factors and medical decision-making around this diagnosis. The challenge to that is that the majority of these patients not receiving aggressive therapy are not being seen at academic medical centers, and so they're not as easy to study. But if we were able to set up these registries, I would want to understand better whether the patients not receiving therapy were deemed ineligible by their providers were refusing therapies or both, and if they were ineligible, why? Are these patients being seen by providers with extensive experience with cystectomy or not? Ideally, these patients should be counseled by high-volume cystectomists. If they're worried about side effects of cystectomy, are they seeing radiation oncologists for trimodality therapy? Can we increase the utilization of aggressive therapy through telehealth and other outreach programs? And would these patients be interested in experimental therapies that allow them to keep their bladders? So all those things I think are interesting and crucial questions that we have to answer through prospective registries.

This transcript was edited for clarity.

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