WHITE RIVER JUNCTION, Vt. — More than 30,000 veterans live with bladder cancer and improving care for these veterans will fill an important gap in cancer care. “This study will help all patients with early stage bladder cancer — that is three-quarters of all patients diagnosed with bladder cancer,” according to Dr. Florian Schroeck, a urologist and researcher at the White River Junction VA Medical Center responsible for the research grant. The research grant will provide $1.1 million in direct funds over four years.
Early stage bladder cancer grows superficially within the bladder. The standard of care is removing the cancer from the bladder by endoscopically “scraping the tumor out” — also called a transurethral resection of bladder tumor. After that, veterans undergo regular check-ups to assess whether cancer has returned within the bladder. The frequency of these check-up procedures should be aligned with the veteran’s risk for cancer: those with high-risk should have check-ups at least three times a year and for those with low-risk only once a year. Recent VA research reveals that veterans do not undergo risk-aligned check-ups; 75 percent of low-risk patients had check-ups too frequently, suffering unnecessary anxiety, discomfort, and cost. Conversely, 31 percent of high-risk patients did not get check-ups frequently enough. Thus, the study will focus on implementing more risk-aligned check-ups by: (1) identifying reasons why veterans do not receive such check-ups, (2) developing strategies that make it easier for patients to undergo risk-aligned check-ups and easier for clinicians to provide them, and (3) testing whether these strategies work in a routine clinical setting. It will help low-risk patients by avoiding unnecessary invasive check-up procedures and will help high-risk patients because they will obtain check-ups with recommended frequency providing assurance that cancer will be detected early should it ever come back within the bladder.
“This study will have immediate real-world clinical impact, as it will investigate and improve real-world clinical practice within the Department of Veterans Affairs (VA),” said Dr. Schroeck, who further explains that, “this study will not only have a near-term impact on bladder cancer care; it will also be relevant for patients with other tumors for which risk-aligned check-ups are recommended. This includes patients with lung or prostate cancer, or with colorectal adenoma. Thus, our focus on risk-aligned check-ups addresses a commonality in cancer research shared across many types of cancer.”
Research will begin within the next three to six months and continue for approximately four years amongst several VA facilities including the one located in White River Junction, Vermont. After the initial study, strategies will be implemented nationally across all VA Medical Centers.
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