Disease-centred advice for patients with superficial transitional cell carcinoma of the bladder

Urologists tend to regard superficial tumours (e.g. pTa or pT1 transitional cell carcinoma of the bladder) as being of low pathogenicity. There is a clearly established link between cigarette smoking and bladder cancer, with incidence, recurrence and mortality being positively associated with duration of smoking and number of cigarettes smoked.

A questionnaire-based audit was undertaken to determine the amount of information being provided by urologists for patients who had been diagnosed with pTa or pT1 transitional cell carcinoma of the bladder about both their disease, its aetiology and appropriate advice regarding life-style change.

A total of 78 patients adequately completed the questionnaire. Of these, 55 (71%) had been smokers at some time, and 24 (31%) continued to smoke at the time of follow-up. Only 26 of these 55 (47%) were aware of their underlying diagnosis. This level of knowledge was similar in non-smokers, of whom only 12 (52%) were aware of their disease. Of the ever-smokers, only 12 (22%) were aware that smoking was a risk factor for the development of bladder cancer, and 7 (13%) were aware that continued smoking could worsen the prognosis. Only 18 (33%) of the 55 smoking patients had been told to stop smoking, for any reason, by their general medical practitioner, and only 4 (7%) had been told to stop by a urologist.

In the urology department in which the audit was performed, patients with bladder cancer were not being provided with adequate information about their disease.