Bladder cancer presents similarly in women and men, but women typically present with later stage cancer. Urologic oncologist Armine Smith, explains our approach to treating bladder cancer as well as the importance of continued research around bladder cancer in women.
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hopkinsmedicine.org/gbci. bladder cancer program is a joint venture between the brady urological institute. Uh Sidney Kimmel Cancer Institute and Greenberg bladder cancer institute. We have a multi disciplinary team of individuals that is involved including urologist, medical oncologist and ancillary staff. The presentation of bladder cancer is very similar but for some reason women tend to be treated and evaluated later. The presentation is usually the mature area which is visible blood in the urine or grocery material or microscopic immature area which is defined as more than three red blood cells per high power field. The problem with detection of women you know as men get referred to urologist fairly promptly. Women tend to be evaluated and treated for U. T. I. S. Undergoing multiple courses of antibiotics sometimes get referred to G. Y. N. So that really delays care and the presentation referral to neurologist is warranted when there is grocery mature area or more than three red blood cells per high power field on the microscopic. Your analysis. Also when there are unexplained urinary symptoms, I think women are a very resilient group of patients and they generally do well after radical mastectomy. Um you know radical mastectomy is one of the highly morbid surgeries and the urology up to 60% rehospitalization or piri operative morbidity risk. A lot of the times this can translate into urinary tract infections and wound infection and slow recovery of bowel. However um When this is performed at the at the higher volume center. These numbers are usually better here. We have established the areas protocols optimized nutritional support rehabilitation before surgery rehabilitation, after the surgery. established postoperative pathways that make the recovery much smoother for the patients quality of life and survivorship issues. And women have been very understudied um looking all across, we really don't have a very good understanding of how women do after bladder preservation and after treatment of non muslim invasive bladder cancer. We do know that a lot of people are affected with mood disorders, depression um and anxiety when given the diagnosis during the treatment and after um after the treatment. And sometimes there is a huge anxiety before every surveillance visit insist ask api lottery cancer can have variable presentation. Patients present with the non muscle invasive versus muscle invasive cancer. Low or high grade sometimes unfortunately see metastatic presentation from the beginning. Uh The patients with a non muscle invasive cancer are treated differently, usually with the resection and the intra vehicle installations of chemotherapy immunotherapy. Some other novel therapies. And there are also candidates for clinical trials if they fail the routine treatments for muscle invasive cancer. We have the options of tri modality bladder preservation which includes you know, radical resection, chemotherapy and radiation to the bladder or radical mastectomy with removal of the bladder and the reconstruction of another urinary diversion to take the place of the bladder here at johns Hopkins, we offer a variety of clinical trials for all the different stages of bladder cancer including um non muscle invasive presentation to metastatic. We also have some bladder preservation trials. And we also are trying to elucidate more the survivorship and psychosocial issues affecting patients after their treatment for bladder cancer. And we do have targeted trials for that as well.