Improving Survivorship for Women with Bladder Cancer

Bladder cancer is more common in men than women yet it tends to present more aggressively and at later stages in women. The treatment paradigm has evolved in recent years.

"Historically speaking over the last 50 years, it's always been chemotherapy followed by consolidative surgery, so removal of your bladder in women, removal of ovaries, the uterus, you take the ovaries, you take the tubes out, but that's have shifted," says urologic oncologist Laura Bukavina. "We're now focusing more on not only preservation of organs, we're also focusing and shifting our goal to potentially organ preservation in terms of the whole bladder preservation. So, there's a spectrum of saving some organs, preservation of nerves, or potentially doing what's called complete organ preservation or bladder preservation programs."

In a recent episode of Cleveland Clinic’s Cancer Advances podcast, Dr. Bukavina addresses:

- The feasibility of preserving organs such as ovaries and the uterus
- Preserving nerve function to help protect sexual function
- Employing neoadjuvant therapy before surgery to further help with organ and nerve preservation
- Supporting patients with social work, mental health, pelvic floor therapy, and more to address the physical and emotional issues that can accompany bladder cancer and bladder cancer treatment

Click the podcast player above to listen to the episode now, or read on for a short edited excerpt. Check out more Cancer Advances episodes at clevelandclinic.org/podcasts/cancer-advances or wherever you get your podcasts.

Excerpt from the podcast:

Dale Shepard, MD, PhD: When you think about quality of life after treatment, this is a really important area, but it's frequently not addressed. The reality
is patients don't mention it, docs don't talk about it. There's time components.
How do you make it work?

Laura Bukavina, MD, MPH: You talk about it. Talk about it like we're talking about it now. You write about it. You make it acceptable. So, many of these patient organization, patient advocate organizations like BCAN, it's a huge topic that the patients are always talking about. So, patients discussing among themselves will make it acceptable for a patient to ask those questions. They sometimes feel ashamed, scared, uncertain if it's the right question, so making it okay to ask questions about organ preservation and sexual function.