A New Era for Bladder Cancer Treatment: Minimizing Costs and Maximizing Care

The economic burden of bladder cancer is undeniable: it has the highest lifetime treatment cost among all cancers, ahead of colorectal, breast, prostate, and lung cancer (Source). By 2030, the projected costs to Medicare are estimated to rise to 11.6 billion dollars (Source).

With looming consequences for today’s healthcare system, it’s critical that the medical community takes a step back to address how we got here – and what therapeutic approaches are needed to change course.

The current burden of bladder cancer care

With over 80,000 new cases per year, bladder cancer ranks as the sixth most common cancer (Source). Almost all cases are urothelial carcinoma (also called transitional cell carcinoma), which starts in the urothelial cells that line the inside of the bladder (Source).

Diagnosis relies on cystoscopy, an invasive and costly procedure that inspects the urinary tract and bladder for signs of cancer. 75% of newly diagnosed cases are non-muscle invasive bladder cancer (NMIBC), a subclassification of urothelial carcinoma where the tumor has not invaded into or beyond the muscle wall of the bladder (Source).

For almost five decades, the standard of care for NMIBC has been Bacillus Calmette-Guérin (BCG) immunotherapy. However, even after initial successful treatment, recurrent tumors in the bladder are all too common, and there is the risk of developing a more aggressive tumor. In fact, NMIBC recurrence rates can be as high as 50% to 70% and progression rates as high as 10% to 30% (Source).

For this reason, most patients need long-term surveillance, typically through repeat cystoscopy and urine cytology testing, beginning three months after treatment ends. If there are no signs of recurrence, cystoscopy and urine testing are usually recommended every three to six months for two years, then six to twelve months for years three and four, and then once a year (Source).

In some cases, repeat treatments may also be recommended. For those with high-risk NMIBC, for instance, maintenance BCG treatment is typically given once per week for three weeks at 3, 6, and 12 months after the initial BCG treatment (Source).

The nature of this frequent treatment cycle poses significant economic implications for patients. According to one study, total median costs at one, two, and five years from start of BCG induction were $29,459, $55,267, and $117,361 respectively (Source).

The promise of precision medicine for the bladder cancer ecosystem

With persistent unmet needs and rapidly growing economic strain, it’s clear that we must take a different approach to bladder cancer care.

Fortunately, the emergence of precision medicine is proving to be a promising way forward. Through clinical trial data and real-world evidence, researchers have been able to pinpoint an increasing number of predictive genomic biomarkers for bladder cancer and advance the development of revolutionary targeted therapies (Source).

In turn, this has opened the door for clinicians to proactively screen patients for specific biomarkers and select individualized treatment plans that are most likely to be effective based on the results (Source). Through this process, we minimize the time spent on potentially ineffective treatment, thereby reducing rates of recurrence and progression – and the economic burden that accompanies them (Source).

That’s why now more than ever, it’s time to embrace the power of precision medicine and step into a new future of bladder cancer innovation.