Immunotherapies in Treatment of Bladder Cancer - Episode 4

Multidisciplinary Care in Bladder Cancer

Elements that are critical to ensuring that patients with bladder cancer are managed appropriately by various healthcare professionals who will likely interact with patients and their family throughout the cancer journey.

Leonard G. Gomella, MD: Our general trend over the years has been this concept of multidisciplinary care, whether it’s for patients with prostate cancer and now increasingly for patients with bladder cancer. I think that when you look at multidisciplinary teams, I think it’s really critical to have certain elements in place. Obviously, the urologist understands a lot of the surgical implications. There are issues with intravesical therapy, which again is often administered by either our advanced practice provider, nurses, medical assistants, depending on the particular environment of the clinic. The interaction I think which has been stressed between the nursing staff actually doing some of the administration and the supervision of the urologist in the clinic is very important.

Things like urostomy management, you really need somebody with ostomy training if you’re going to be a comprehensive, multidisciplinary team. Certainly, on that multidisciplinary team it’s very important to have other support individuals. At our multidisciplinary clinics we have social workers that are involved. While genetic counseling is not yet really firmly embedded in bladder cancer, I’m sure it’s going to be getting there very quickly. Having the availability to have genetic counselors, dietitians to help these patients in times of need and also other social support—psychological support—should be available. You don’t need to have them actually in the clinic but you need to have the ability to refer to other specialists.

We can’t ignore radiation oncology. There’s a lot of work that goes on with bladder preservation today that we’re partnering with our radiation oncologists. The core members of the multidisciplinary team are the urologist, the medical oncologist, and radiation oncologist. Then, we need support staff to help us both in the nursing context and then other healthcare providers to that specialty in certain areas. We’ve been doing multidisciplinary care. In fact, 2021 was the 25th anniversary of our GU [genitourinary] multidisciplinary clinic at the Kimmel Cancer Center, so we’re very engaged with multidisciplinary care. It’s not only good for the patient and the family, it’s also good for our trainees and all the other disciplines who get to work in that environment. I really think that the multidisciplinary team for all of GU oncology, and in particular for prostate and bladder cancer, is the way to go.

Transcript edited for clarity.