Bladder Cancer Disease Awareness and Patient Support

Bladder cancer develops when healthy cells in the bladder lining undergo genetic changes and grow out of control, sometimes resulting in a tumor.¹ The most frequent type of bladder cancer is urothelial carcinoma (UC) with less common varieties including squamous-cell carcinoma, small-cell carcinoma, and adenocarcinoma.¹

Although anyone could be diagnosed with bladder cancer, some risk factors can contribute to a higher risk of this cancer.² Smoking, exposure to certain chemicals, and a family history of the disease are all major risk factors, although bladder cancer is more prevalent in men than in women and becomes more common with age.^2,3 The number of people living with bladder cancer in the United States was reported to be 723,745 in 2018.³ The earlier bladder cancer is detected, the greater the chance of survival 5 years following diagnosis.³ Localized bladder cancer has a 5-year relative survival rate of 69.6%, and approximately 33.6% of bladder cancer cases are diagnosed at the local stage.³ However, once bladder cancer metastasizes, the 5-year survival rate drops to 6.4%.³

Healthcare practitioners may recommend bladder cancer testing for those who are at an increased risk, such as individuals who have already had bladder cancer, who have specific bladder birth defects, or who are exposed to particular chemicals at work.⁴ Bladder cancer has been linked to some industrial pollutants.⁴ It can be caused by aromatic amines, such as benzidine and beta-naphthylamine, which are sometimes employed in the dye business.⁴ Workers in other industries who work with particular organic substances may also be more susceptible to bladder cancer.⁴ Rubber, leather, textiles, and paint manufacturers, as well as printing enterprises, are industries with higher hazards.⁴ Painters, machinists, printers, hairdressers (due to excessive exposure to hair colors), and truck drivers (likely because of exposure to diesel fumes) are among the other professions with a higher risk of bladder cancer.⁴ Diagnosis for UC may involve using a scope to investigate the inside of the bladder (cystoscopy), taking a sample of tissue for testing (biopsy), evaluating a urine sample (urine cytology), and imaging tests such as computed tomography.⁵ While diagnostic tests may detect certain bladder cancers early on, they may also fail to detect some, and more research is required to determine the tests that are the most effective as screening tools.⁴

Sacituzumab govitecan-hziy (SG) is indicated for the treatment of adult patients with locally advanced or metastatic UC who have previously received a platinum-containing chemotherapy and either a programmed death receptor 1 (PD-1) or programmed death-ligand 1 (PD-L1) inhibitor.⁶ The TROPHY trial evaluated SG in 112 patients with locally advanced or metastatic UC who received prior treatment with a platinum-containing chemotherapy and either a PD-1 or PD-L1 inhibitor.⁷ In the study, SG measured an overall response rate of 27.7% and a median duration of response of 7.2 months, which resulted in the US Food and Drug Administration giving SG accelerated approval for use in adult patients with locally advanced or metastatic UC who have previously received a platinum-containing chemotherapy and either a PD-1 or PD-L1 inhibitor.⁷ The most common adverse effects are neutropenia, nausea, diarrhea, fatigue, alopecia, anemia, vomiting, constipation, decreased appetite, rash, and abdominal pain, all with an incidence of ≥25%.⁷

Patients living with bladder cancer and their families/caregivers can all benefit from being provided with a variety of supportive resources.⁶ Support services, information, and other resources are available through the Bladder Cancer Advocacy Network (BCAN), the American Cancer Society, and the Cancer Support Community.⁶ BCAN (bcan.org) connects people to a community of patients, caregivers, survivors, advocates, and other research professionals dedicated to bladder cancer.⁶ The American Cancer Society (cancer.org/treatment/support-programs-and-services) can help patients with bladder cancer find local support programs and resources, and the Cancer Support Community (cancersupportcommunity.org/bladder-cancer) provides access to information, support, and other bladder cancer resources.⁶

Receiving a diagnosis of bladder cancer can be overwhelming and frightening, not only for the patient but also for their family and friends.⁸ The coping process begins with the patient absorbing the news of a cancer diagnosis and connecting with their healthcare team.¹ Other measures include seeking help, counseling, organizing health information, ensuring that all of the patient’s questions are answered, and participating in the treatment options and other decision-making processes.¹ Patients should ask for clarification from their healthcare team on any issues and discuss with them as needed.¹ It is a physical, mental, and emotional journey for patients and their supporters throughout the diagnosis, treatment, and recovery process.¹ Survivorship begins with the decision-making that happens at the time of diagnosis and continues throughout the treatment process.⁹

References

1. ASCO (American Society of Clinical Oncology) Answers. Cancer.Net. Doctor-Approved Patient Information from ASCO. Conquer Cancer, The ASCO Foundation. 2019.
2. Memorial Sloan Kettering Cancer Center. Bladder cancer causes, risk factors, and prevention. www.mskcc.org/cancer-care/types/bladder/bladder-prevention-risk-factors. Accessed February 7, 2022.
3. National Cancer Institute. Cancer stat facts: bladder cancer. https://seer.cancer.gov/statfacts/html/urinb.html. Accessed February 7, 2022.
4. American Cancer Society. Can bladder cancer be found early? Updated January 2019. www.cancer.org/cancer/bladder-cancer/detection-diagnosis-staging/detection.html. Accessed February 7, 2022.
5. Mayo Clinic. Bladder cancer. www.mayoclinic.org/diseases-conditions/bladder-cancer/diagnosis-treatment/drc-20356109. Accessed February 7, 2022.
6. Gilead patient brochure. Trodelvy (Sacituzumab govitecan-hziy) in mUC. Accessed December 15, 2021.
7. Product information (PI) for Trodelvy (Sacituzumab govitecan-hziy). Sec 14.2. Clinical Studies. Updated April 2021. Accessed November 20, 2021.
8. Bladder Cancer Advocacy Network (BCAN). https://bcan.org. Accessed February 7, 2022.
9. Cancer Community Support. Bladder cancer. www.cancersupportcommunity.org/bladder-cancer. Accessed February 7, 2022.