image: A new national clinical trial led by Dartmouth Cancer Center clinical researcher and urologist Florian R. Schroeck, MD, will determine whether a less intensive follow-up plan for bladder cancer patients can deliver the same outcomes while improving quality of life.
Credit: Dartmouth Health
A new national clinical trial explores a long-standing question in bladder cancer care: Can a less intensive follow-up plan deliver the same outcomes with a better patient experience?
Led by Dartmouth Cancer Center (DCC) clinical researcher and urologist Florian R. Schroeck, MD, and conducted through the U.S. Department of Veterans Affairs (VA), the study focuses on patients with high-grade, early-stage bladder cancer.
Because this group is at higher risk for cancer coming back, they require ongoing check-ups after initial treatment. For decades, the standard approach has involved cystoscopy (a procedure that uses a camera to examine the bladder) every three to four months. While effective, cystoscopy can be uncomfortable and burdensome, especially when repeated over many years.
“The frequency comes from historical precedent dating back to 1936,” explains Schroeck. “But we don’t actually have scientific evidence that this frequency is necessary.”
Urgent need for clinical study
VATSIT, which stands for “VA Randomized Trial of Surveillance Intervals after Transurethral Resection of High-Grade Bladder Tumors,” will compare the current approach with a low-intensity strategy that relies more on non-invasive urine testing.
“Patients in the lower-intensity group will still be closely monitored, but with far fewer invasive exams, potentially cutting the number of procedures by more than half over several years,” says Schroeck.
Beginning at several VA hospitals, VATSIT will expand to more than 30 sites nationwide. Over 10 years, researchers will track outcomes such as survival, cancer progression, need for additional treatment, and quality of life.
“The goal is not to reduce care, but to refine it,” says Schroeck, whose team aims to show that fewer procedures are just as effective at keeping patients healthy.
Why the VA?
Bladder cancer is one of the most common cancers among veterans, and cystoscopy is one of the most frequently performed procedures in the VA healthcare system. Reducing unnecessary procedures could spare thousands of patients discomfort and lower healthcare costs without compromising quality of care.
Method of Research
Randomized controlled/clinical trial
Subject of Research
People