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Bladder cancer needs research, politics & solutions – POLITICO

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Alan McDougall, Senior Vice President of Medical Affairs at Astellas Pharma Europe

Bladder cancer is one of the most common types of cancer in Europe, claiming an estimated 67,000 lives in 2020. In Europe, healthcare systems spend around €5 billion a year treating and caring for people with bladder cancer. Despite this, patients still face a significant unmet need.

To mark Bladder Cancer Awareness Month in May, POLITICO Studio spoke to Alan McDougall, Senior Vice President of Medical Affairs at Astellas Pharma Europe Ltd, about bladder cancer, the impact it is having on patients, healthcare systems and economies in Europe and what can be about it made.

Alan worked as a medical doctor for 14 years before moving into the pharmaceutical industry. Astellas is a pharmaceutical company best known for transplantation, urology and oncology.

Q. What have been the biggest challenges for cancer patients in recent years?

A In recent years, COVID-19 has been the biggest challenge. With access to the healthcare system not being as easy as before, it became difficult to see a doctor. If you think about the age group that people with bladder cancer are typically in – early 70s – these people have been more reluctant to go to health care facilities where they could get COVID-19 because they are at higher risk. People in cancer treatments have been delaying their treatment – either a delay in starting it or missing classes, which is obviously very problematic.

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via Shutterstock

Q. Why is bladder cancer treatment important for Europe in particular?

A So it’s interesting that bladder cancer is more common in the most developed countries. It is among the top 10 most common types of cancer in Europe and is more common in men than women, with women having worse health outcomes than men. And yet many people would be surprised by this. Most people will not have heard of bladder cancer, while most people will be familiar with prostate cancer, colon cancer, and breast cancer.

About half of people with bladder cancer will have a recurrence. Bladder surgery can be incredibly complex and also very damaging, ending up damaging many other organs at the same time, and that has its own treatment costs. There is also a significant toll on patients’ mental health.

The operation alone, the follow-up care, makes bladder cancer one of the highest lifetime costs of all types of cancer. The cost to society is enormous. In Europe, around 5 billion euros are spent annually on the treatment of bladder cancer.

Productivity losses due to mortality and morbidity for bladder cancer patients in Europe are €769 million and €329 million, respectively, impacting patients and the wider economy.

Q. What are the most important interventions in the management of the disease and what can still be done to improve patient outcomes and quality of life?

A We have treatment guidelines for bladder cancer – well-designed, evidence-based guidelines. This begs the important question: is everyone following them? Inconsistency in bladder cancer treatment is a barrier to improved patient outcomes, from diagnosis to treatment.

Patients with advanced bladder cancer have very poor outcomes, with five-year survival rates of about 5 percent. It is therefore important that we have a pathway that allows patients to access the right treatment at the right time.

Q. What are the major challenges to the effective treatment of bladder cancer now and in the future?

A Traditionally, patients with bladder cancer, particularly those with advanced forms of the disease, have had limited treatment options. When I was first qualified in 1984 I remember being in a urology ward where we had patients with bladder cancer and for people with metastatic cancer the treatment was a BCG (Bacillus Calmette-Guérin) vaccine. We still do that today, almost 40 years later. Although there has been a lack of innovation in bladder cancer, the good news is that new treatments have been developed for patients.

GPs need to be more aware of treatment options for bladder cancer patients at all stages of disease development so that patients have access to the right medicines for their bladder cancer.

Q. Regarding cancer policy, what role could the implementation of the European Beating Cancer Plan play in improving patient outcomes and quality of life for patients with bladder cancer?

A This EU policy and research framework is good news for all cancer patients and bladder cancer patients in particular. The EU has earmarked €4 billion for implementation and it’s great to see a focus on cancers where there is unmet need, a conversation that should include bladder cancer. Relevant actions for the bladder cancer patient community include, for example, those focused on “reducing exposure to hazardous substances and radiation” in the work environment and ongoing efforts to promote cancer health literacy.

Some of the initiatives in Europe’s Beating Cancer Plan address the effects of alcohol and tobacco. We know that tobacco is a significant risk factor for bladder cancer in particular: smokers have a 2 to 3 times higher risk of developing bladder cancer. I hope that European initiatives will make a positive difference, including in areas such as early detection, where research into a bladder cancer screening test could make a real difference for patients.

Looking ahead, there is much to be optimistic about, but more investment and collective commitment are needed to raise the profile of bladder cancer, with the patient experience at the heart of that effort.

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Fry Electronics Team

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