Strategies for the Management of Recurrent Low-Grade Bladder Tumors


This episode focuses on the complex management of recurrent low-grade bladder tumors and highlights the limitations and challenges of current treatments, including intravesical chemotherapy and BCG, and underscores the need for better therapies and clinical trials in this area.

This is a synopsis of the Viewpoints video series featuring moderator, Sam S. Chang, MD, MBA, from Vanderbilt University School of Medicine, and panelists Gary Steinberg, MD, FACS, from Rush University Medical Center, Mark Tyson, MD, of Mayo Clinic Phoenix, Roger Li, MD, from Moffitt Cancer Center, and Sandip M. Prasad, MD, MPhil, of Morristown Medical Center.

In Episode 5, the panelists explore the challenges and strategies in managing recurrent low-grade bladder tumors, particularly in older patients. The panel discusses a hypothetical case of a 50-year-old patient with recurrent low-grade, multifocal bladder tumors, emphasizing the unmet need for better therapies in this patient population. Dr. Steinberg expresses concerns about the limited efficacy of intravesical Bacillus Calmette-Guérin (BCG) therapy and gemcitabine for these patients. He advocates for the use of blue light cystoscopy during Transurethral Resection of Bladder Tumor (TURBT) to improve surgical outcomes, as blue light can reveal small tumors that are not visible in white light. The discussion then addresses the impact of repeat TURBTs and cystoscopies on younger patients, highlighting the anxiety and morbidity associated with these procedures. The importance of de-escalating care, especially for lower-risk diseases, is underlined to maintain efficacy while minimizing patient burden. The panelists also explore the role of active surveillance in managing these patients, with a focus on less invasive approaches for older and sicker patients. They stress the importance of histological confirmation to ensure accurate diagnosis and appropriate management. The episode underscores the need for ongoing clinical trials to develop better treatment options for patients with recurrent low-grade bladder tumors. The panelists also highlight the significance of accurately assessing tumor grade, noting a trend towards higher-grade readings in pathology, and the implications this has for predicting recurrence and managing patient care.

In summary, Episode 5 of the Urology Times® Viewpoints series provides an in-depth look at the complexities of managing recurrent low-grade bladder tumors. The panelists emphasize the importance of individualized patient care, the need for better therapies, and the challenges in current treatment protocols.

*Video synopsis is AI-generated and reviewed by Urology Times® editorial staff.

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