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What should Europe start, stop and do collectively with bladder cancer?

Submitted by on 30 Sep 2016 – 17:37

In the UK, around 98,000 people are living with bladder cancer and over 10,000 new cases are diagnosed every year with 5,000 deaths. In the EU, there are approximately 123,135 new cases and 40,252 deaths attributed to bladder cancer per year. It is the fifth most common cancer in Western societies but receives a fraction of the research and awareness funding of other cancers. The field is characterised by a lack of scientific advancement. There is therefore an urgent need to overhaul most aspects of bladder cancer management so that improvements in long-term outcomes can rival those seen in other common malignancies.

Bladder cancer is also the costliest lifetime cancer to treat per patient, as patients have to be constantly monitored for potential recurrence, so more efficient and cheaper diagnostic tests need to be developed. In England alone bladder cancer accounts for a total annual cost to the NHS of circa £65million. Early diagnosis means there is greater chance of survival. Research and clinical trials are vital to unlocking markers for diagnostic tests and drugs for treatment and cures.

Mortality rates for bladder cancer in the UK have not really changed since the NHS was created. Meanwhile, five year survival rates for prostate and kidney cancers have significantly improved in this timeframe. Living in the UK also means that people’s chances of survival are lower than those in other European countries with comparable incidence rates, with overall deaths from the disease higher in England, and the rate appears to be getting worse, not better.

So what could or should we be doing collectively across the EU that will also help to improve survival and outcome rates in the UK?
First, bladder cancer has always been a ‘Cinderella’ cancer in the UK. Even Cancer Research UK has not designated this a priority cancer, despite the lack of new treatments. Charities such as The Urology Foundation are doing what we can to fund research but a more concerted drive is necessary to achieve significant breakthrough in diagnosis and prognosis.

We desperately need more research to:
• Develop new tests which will enable earlier detection of bladder cancer in patients.
• Assess new technologies such as Hyperthermia and electromotive drug administration.
• Develop prognostic and predictive biomarkers to identify patients who may benefit from chemotherapy or radiotherapy along with surgery.
• Investigate surveillance intervals with an aim to improve quality of life for patients.
• Improve the management of the disease that positively impacts on survival.

Collaboration – both pan-EU and, more broadly, international – is fundamental to research. Where EU grants facilitate collaboration, it can help the member states to achieve better results than if they were acting in isolation.

Second, we need to be better at coordinating and using patient data to help innovative treatments to be brought more quickly to patients.
The UK is fortunate in that the cradle-to-grave care provided by the NHS to our socially and ethnically diverse large population provides opportunities for research which are unparalleled internationally. Analysis of patients’ data – such as clinical care data or data from clinical trials and observational studies (among others) – has underpinned our understanding of the disease and enabled development of new treatments and diagnostics, improving outcomes for patients and the wider population.

By Louise de Winter, Chief Executive, The Urology Foundation