A new national clinical trial led by researchers at Dartmouth Health’s Dartmouth Cancer Center (DCC) is exploring whether patients with high-grade, early-stage bladder cancer can safely be monitored with fewer invasive procedures while maintaining the same quality of care.
The study, led by DCC clinical researcher and urologist Florian R. Schroeck, MD, MS, and conducted through the U.S. Department of Veterans Affairs, focuses on surveillance strategies for patients at higher risk of bladder cancer recurrence following initial treatment.
For decades, the standard follow-up approach for these patients has included cystoscopy – a procedure that uses a camera to examine the bladder every three to four months. While effective, repeated cystoscopies can be uncomfortable and burdensome for patients over time.
“The frequency comes from historical precedent dating back to 1936,” Schroeck said. “But we don’t actually have scientific evidence that this frequency is necessary.”
The study, known as VA Randomized Trail of Surveillance Intervals after Transurethral Resection of High-Grade Bladder Tumors (VATSIT), will compare the current high-intensity surveillance schedule with a lower-intensity approach that relies more heavily on noninvasive 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,” Schroeck said.
The trial is launching at several VA hospitals and is expected to expand to more than 30 sites nationwide. Over the next 10 years, researchers will evaluate outcomes including survival, cancer progression, need for additional treatment and patient quality of life.
“The goal is not to reduce care, but to refine it,” said Schroeck, whose team aims to show that fewer procedures are just as effective at keeping patients healthy.
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 lower discomfort and healthcare costs for thousands of patients without compromising quality of care.
“This study gives us the opportunity to rigorously test whether we can do less—and still do just as well for people living with bladder cancer,” Schroeck said.
About Dartmouth Cancer Center
Since 1972, Dartmouth Cancer Center (DCC) has combined groundbreaking and advanced cancer research at Dartmouth and the Geisel School of Medicine with award-winning, personalized, compassionate, patient-centered cancer care and clinical trials. At its flagship location at Dartmouth Health’s Dartmouth Hitchcock Medical Center, with 14 locations across New Hampshire and Vermont, DCC is one of fewer than 60 National Cancer Institute-designated Comprehensive Cancer Centers nationally. Each year, DCC manages 74,000 appointments, treats more than 4,500 newly diagnosed patients, and currently offers more than 240 active clinical trials. DCC remains committed to excellence, outreach and education. DCC strives to create new knowledge and impact, accelerate integrated and collaborative research to prevent and cure cancer, enhance survivorship and promote cancer-related health equity. Learn more at cancer.dartmouth.edu.
About Dartmouth Health
Dartmouth Health, New Hampshire’s only academic health system and largest private employer, serves patients across New England. Dartmouth Health provides access to more than 2,300 providers in nearly every area of medicine, delivering care at its flagship hospital, Dartmouth Hitchcock Medical Center (DHMC) in Lebanon, NH. Its network of hospitals, outpatient centers, clinics and home care facilities, spans a broad geographical area. Year after year, DHMC is named the #1 hospital in New Hampshire by U.S. News & World Report, and is consistently recognized for high performance in numerous clinical specialties and procedures. Dartmouth Health includes Dartmouth Cancer Center, northern New England’s only National Cancer Institute-designated Comprehensive Cancer Centers and one of less than than 60 total nationally; Dartmouth Health Children’s, which includes the state’s only children’s hospital (Children’s Hospital at DHMC/CHaD) and more than 20 locations around the region; eight member hospitals in Lebanon, Keene, Claremont, Hampstead, and New London, NH, and Windsor and Bennington, VT; Dartmouth Health Home Care; Dartmouth Health Connected Care Center for Telehealth, serving patients as far away as Texas; and more than 30 primary and multi-specialty clinics across New Hampshire and Vermont. Through its partnership with Dartmouth College, Dartmouth’s Geisel School of Medicine and the White River Junction VA Medical Center, Dartmouth Health trains nearly 400 medical residents and fellows annually and performs cutting-edge research and clinical trials with international impact. Dartmouth Health and its more than 16,000 employees are committed to serving the healthcare needs of everyone in the communities it serves and to providing every patient with exceptional, state-of-the-art, personalized care. Learn more at dartmouth-health.org.