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Dr. Smith on the impact of bladder cancer treatment on patients’ work productivity


"From a urology provider perspective, we should be discussing this with our patients [with bladder cancer] as they make their treatment decisions," says Angela Smith, MD, MS.

In this video, Angela Smith, MD, MS, highlights findings from the study, “The effect of treatment on work productivity in patients with bladder cancer,” for which she served as a co-author. Smith is a professor of urology and the associate dean for faculty affairs and leadership development at the University of North Carolina, Chapel Hill.

Video Transcript:

This is a study that looked at work productivity, which is a unique, or at least an innovative look at the effect of treatment in terms of bladder cancer. This was geared toward evaluating how patients with both non–muscle-invasive bladder cancer and muscle-invasive bladder cancer, how their treatments might cause a variety of disruptions, we could say, in the way that they work. This is one of the first studies that has looked at this. It was led by Lauren Ahlschlager [, MD, MPH], and was recently published.

We looked at the work productivity and activity impairment questionnaire. It's a cross sectional study where we partnered with the Bladder Cancer Advocacy Network and sent an email to the Patient Survey Network to get a better sense of patients who were treated a variety of ways. For example, bladder preservation vs cystectomy for either non–muscle-invasive or muscle-invasive bladder cancer.

We found some interesting findings. The first is that for patients with non–muscle-invasive bladder cancer who underwent cystectomy, they were more likely to have activity impairment, whereas those who underwent bladder preservation with non–muscle-invasive bladder cancer were more likely to have absenteeism, meaning that they were outside of work. This has always been a concern. If patients undergo bladder preservation, there's a high burden on those patients to seek treatment for surveillance, but also for intravesical therapies that can be once a week for 6 weeks at a time and then maintenance therapies thereafter. So, that wasn't necessarily surprising, but it's one of the first studies that looked at work productivity and how these types of treatments [affect] it, which to be quite honest, from a urologist perspective or a urology provider perspective, we should be discussing this with our patients as they make their treatment decisions.

We also found that [for] patients with muscle-invasive bladder cancer who underwent cystectomy, that was actually protective against presenteeism and productivity loss. So, there's a lot of interesting highlights that we noted, but I think the key is that further work is needed to better understand how our treatments [affect] the way in which patients function in work and in their personal lives. That's what I would describe as an unmet need, because when these treatment decisions are being made, they are highly personal, and studies like this shed some light on how work productivity might be affected.

This transcription has been edited for clarity.

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