Catto - Figure 26
Risk Categories in non-muscle-invasive bladder cancer
FIG. 26: As a consequence, within the NICE we now recommend that patients with low-risk NMI bladder cancer who have no recurrence at 3 and 12 months should be discharged and re-referred only on return of symptoms.[27] Whilst it is counter to what many urologists believe is necessary, this approach leads to better education and engagement with patients. It also frees up scheduling in the department to expedite patients with new symptoms and re-focuses efforts toward treating more aggressive disease in a more aggressive fashion.
Within Sheffield, we have set up a program to have this process audited by my colleague, James Hall, FRCS(Urol), consultant urological surgeon at Sheffield Teaching Hospitals, who has calculated that we are now saving 30 cystoscopies per month, 12 months of the year. This has created a larger capacity to see patients with visible hematuria faster and, perhaps more importantly, see women with recurrent, difficult-to-treat urinary infections, some of whom will turn out to have carcinoma in situ or occult invasive cancers.
References
National Institute for Health and Care Excellence (NICE). Bladder cancer: diagnosis and management: NICE guideline [NG2]. London, UK: NICE; 2015 https://www.nice.org.uk/guidance/ng2 Accessed July 22, 2017
