May 29, 2024
The National Cancer Institute reports that bladder cancer is the sixth most common cancer in the United States. And the American Cancer Society estimates that 83,190 new cases of bladder cancer will occur in 2024 — 63,070 of those diagnosed in men.
Timothy D. Lyon, M.D., is a urologic oncologist at Mayo Clinic Comprehensive Cancer Center in Jacksonville, Florida. Dr. Lyon's subspecialty training has helped him glean expertise in the multidisciplinary care planning that is often necessary for patients with bladder cancer.
Here, Dr. Lyon answers questions about the clinical and research advancements he has observed in bladder cancer care today.
How is bladder cancer care different today from in the past?
Bladder cancer is more common than most people think, and many patients with bladder cancer need multiple types of therapy and a multidisciplinary team. About three-quarters of diagnoses are noninvasive, and we're often able to treat those patients with medication applied inside the bladder.
The standard of care is a bladder wash with a medication called bacille Calmette-Guerin (BCG). Unfortunately, the industry has experienced national shortages of BCG in recent years, making it difficult for many practices to access the medication.
Many patients have positive outcomes with BCG. But for those who do not — or for those who cannot get access to BCG — there are several recently approved medications and clinical trials available that may allow patients to keep their bladders.
How are you and your team helping to improve quality of life for patients with bladder cancer?
Historically, patients who did not respond to BCG had to undergo a cystectomy, which is a major, life-altering surgery. While cystectomy remains the best option for many patients, thankfully we now have access to multiple new intravesical therapies to provide our patients with more options to help retain their bladders.
One new treatment my team and I offer is the FDA-approved gene therapy called nadofaragene firadenovec. The medication uses a genetically modified virus to help the body produce interferon, leading to an anticancer immune response in the bladder. The therapy is given only once every quarter. So not only are patients receiving a treatment that allows them to keep their bladders but they are also receiving a less intense course of therapy with fewer visits to the hospital.
We're also working on innovative ways to reduce barriers in access to care by bringing intravesical treatment into patients' homes, which we think can help reduce the burden of bladder cancer treatment on our patients.
How is clinical research advancing bladder cancer care?
Clinical research has allowed for the advancements in bladder cancer care we are using today — but we're not done yet. Clinical trials exist because we aren't satisfied with the results of available treatments. Perhaps they're not effective in every patient or have a high burden of therapy, making them hard to receive.
There are several other open clinical trials investigating new medications administered inside the bladder in a variety of scenarios. For example, we are currently accruing for a study for patients with high-grade, nonmuscle invasive bladder cancer using a drug called TARA-002, which is delivered directly into the bladder and has shown some promising early signs of activity.
How can you and your team support patients with bladder cancer?
The treatment landscape for bladder cancer has evolved significantly in the last 10 years. For decades, we were practicing with very little drug development — but now, the market has become very crowded. It can be challenging to know which therapy is right for a patient and at what point in their treatment plan it should be provided.
Here at Mayo Clinic, I work with a team of highly specialized colleagues. We can provide the full gamut of care for patients with localized and metastatic disease and can also provide a consultive service for external healthcare professionals to talk through a patient's care plan and share about the new and advanced therapies that are now available. We are truly a one-stop shop for patients facing bladder cancer.
For more information
National Cancer Institute. Cancer stat facts: common cancer sites.
American Cancer Society. Key statistics for bladder cancer. 2024.
Refer a patient to Mayo Clinic.