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Management of Superficial Bladder Cancer in Elderly Patients

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Management of Urological Cancers in Older People

Part of the book series: Management of Cancer in Older People ((volume 1))

Abstract

The management of non-muscle-invasive bladder cancer (NMIBC) in the elderly is complex and must be tailored to the individual needs and the physical capacity of this particular group of patients, taking into account the frailty status and life expectancy. On one hand, treatments that may be required might further stress an already vulnerable organism, carrying the risk of being more harmful to the patient than the disease itself. On the other hand, a surprisingly high cancer-specific mortality has been shown even in this old age group, which makes active treatment, and not only palliative approach, advised in fit categories. The issue of reduced efficacy of intravesical therapy, such as BCG, with advancing age further complicates the picture. More radical treatment such as early cystectomy has been shown to be feasible also in octogenarians, keeping in mind that the risk of intraoperative death or major complications becomes relevant in advanced age groups. In this respect, device-assisted administration of intravesical therapies will play an increasing role in the future. Unfortunately, up-to-date, no specific guidelines exist to guide the physician choosing the optimum management of these older patients, who too often end up receiving substandard care.

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Authors and Affiliations

  1. Department of Urology, A.O.U. San Giovanni Battista Molinette, University of Turin, Turin, Italy

    Marco Oderda M.D. & Paolo Gontero M.D.

  2. Department of Urology, University Hospital Leuven, Leuven, Belgium

    Steven Joniau M.D.

Authors
  1. Marco Oderda M.D.
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  2. Paolo Gontero M.D.
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  3. Steven Joniau M.D.
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Corresponding author

Correspondence to Steven Joniau M.D. .

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Editors and Affiliations

  1. Lyon-RTH Laënnec School of Medicine, Lyon, France

    Jean-Pierre Droz

  2. University of Liverpool, St Helens Teach, Marshalls Cross Road, St Helens, WA9 3DA, United Kingdom

    Riccardo A. Audisio

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© 2013 Springer-Verlag London

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Oderda, M., Gontero, P., Joniau, S. (2013). Management of Superficial Bladder Cancer in Elderly Patients. In: Droz, JP., Audisio, R. (eds) Management of Urological Cancers in Older People. Management of Cancer in Older People, vol 1. Springer, London. https://doi.org/10.1007/978-0-85729-999-4_16

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  • DOI: https://doi.org/10.1007/978-0-85729-999-4_16

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  • Publisher Name: Springer, London

  • Print ISBN: 978-0-85729-986-4

  • Online ISBN: 978-0-85729-999-4

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