By Toby Knight
Bladder cancer continues to be a significant focus in UK medical discussions, with efforts intensifying to improve diagnosis and treatment. A study conducted between 2013 and 2019, using real-world data from NHS England, has provided valuable insights into trends surrounding bladder, upper urinary tract, and urethral cancers (BJU Int. 2023 Jun;131(6):734-744).
Key challenges
As of 2019, 150,816 people were living with these cancers in England, with 75% being men. Additionally, the study highlighted several key challenges faced by patients and healthcare providers, underscoring the need for improved diagnostic and treatment pathways.
One major finding was the need for better diagnostic accuracy. For example, several barriers, including inconsistent fast-track referrals, were identified. Women are particularly vulnerable to misdiagnosis, with many initially treated for urinary tract infections (UTIs) before a correct bladder cancer diagnosis is made. In fact, 63% of women diagnosed with bladder cancer were first misdiagnosed with a UTI, emphasising the need for greater awareness and education throughout the healthcare system
The study found that 41% of patients were not referred through an urgent pathway, and 12% were diagnosed only after an emergency hospital admission. Consequently, early diagnosis is crucial for effective treatment. Expanding access to urgent pathways remains essential. The Getting It Right First Time (GIRFT) programme, led by John McGrath, showed that early diagnosis significantly reduces post-surgery readmission rates compared to late-stage diagnoses.
In terms of treatment, the study highlighted areas for improvement. Moreover, radiotherapy, chemotherapy, and multimodal treatments remain standard, but survival rates have not increased. Radical treatments, such as the combination of radiotherapy and chemotherapy, offer the best outcomes. Despite this, 29% of patients with muscle-invasive bladder cancer did not receive these treatments. This clearly indicates the need for better access to more effective care.
Fight Bladder Cancer’s commitment
Nevertheless, encouraging progress has been made. A Fight Bladder Cancer roundtable in September 2023 focused on raising public awareness and strengthening bladder cancer care pathways. Furthermore, new initiatives, such as the introduction of nurse mentorship programmes in London, are helping to close care gaps. While much work remains, these steps represent promising progress.
We remain committed to improving outcomes for all affected by this disease. Therefore, our mission is to raise awareness, educate, and support patients and carers. Our team, many with personal experiences of bladder cancer, understand the challenges faced throughout the journey, from diagnosis to life post-treatment. As a result, we provide resources on symptoms, treatment options, and living well beyond cancer, and we foster a supportive community where individuals can connect with others who have shared similar experiences.
We are proud to have launched our policy white paper, ‘Bladder Cancer Services: A Roadmap for Change,’ in May 2024. This paper outlines key recommendations to enhance bladder cancer care across the UK, including more educational resources for healthcare professionals, genomic testing, and better referral pathways.
Although challenges remain, with continued focus, support, and investment, we can drive lasting improvements for bladder cancer patients across the UK.