How are symptoms and side effects of bladder cancer managed? Bladder cancer specialist Dr. Piyush Agarwal discusses some of the common issues patients may experience and emphasizes the impact and importance of clear communication with the healthcare team.
Dr. Piyush K. Agarwal is the Director of the Bladder Cancer Program at the University of Chicago Medicine Comprehensive Cancer Center (UCCCC), where he also serves as Professor of Surgery, Vice Chief of Urology, and Fellowship Director of Urologic Oncology. Learn more about Dr. Agarwal.
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Transcript
Katherine Banwell:
Symptoms of bladder cancer and side effects of treatment can vary widely. How do you approach symptom management with your patients?
Dr. Piyush Agarwal:
I tell them up front what you can expect are things such as frequency, urgency of urination, occasionally incontinence because of the urgency; waking up at night, more nocturia, and sometimes some burning with urination. And so, these are situations where I tell the patients, “Be aware of the symptoms.” A lot of times these symptoms are short-lived after a treatment or a surgery. If these treatments continue to – if these symptoms continue to persist, we’ll often use a variety of drugs, and these could be anticholinergics, to try to expand the bladder and decrease the urgency.
They can be anesthetics for the urinary tract, that try to numb the urethra so that there’s less burning with urination. Sometimes it could be medications that help particularly in a man. They can basically relax the prostate to make it easier to urinate. There are some drugs we can use to make the symptoms a little bit better. There are some other drugs we can use that are sort of last resort medications.
For the most part, if patients are kind of counseled, you can expect your urinary symptoms to get potentially worse after an intervention, but reassure them that they should get better slowly over time. Then they’re less concerned about it. There are some medications we can use, albeit limited efficacy. And there are some patients that have just such profound symptoms that we can’t treat them further, and we have to think of other ways to treat them. For the most part, we can treat most patients and get them through these therapies.
Dr. Piyush Agarwal:
Why is it so important for patients to report side effects or new symptoms to their care team? And why is early intervention critical?
Piyush Agarwal:
If patients inform us about their symptoms with standard of care medications, it is the earlier we know about a symptom, the earlier we can prescribe a treatment or we could modify a dose of our intervention so that we can make it more tolerable to patients.
There’s good data, with modifications in dose, with reducing the frequency, with potentially adding an antibiotic, we can potentially make treatments more tolerable. We can’t really do those things if the patients don’t report it, so it’s very important that patients communicate with their providers about their symptoms.