“Ten years ago, there were relatively few treatment options [for bladder cancer] compared to what we have today which is a relative wealth of options,” said Debasish Sundi, MD, a James urologist and bladder cancer specialist. In this episode, Dr. Sundi explained the function of the bladder (storing urine), the different types of bladder cancer (contained within the bladder and metastatic), how new immunotherapies have led to better options and outcomes, and his research which focuses on identifying the biomarkers in a patient’s bladder cancer by analyzing their urine, instead of a more invasive procedure using a scope.

There are about 80,000 new cases of bladder cancer diagnosed ever year in the United States and “about 75 to 80 percent are in males,” Dr. Sundi said, adding “the number one cause is exposure to tobacco smoke and tobacco products.” The primary symptom is blood in the urine. “If you see blood in your urine, even if it’s just pink, it is worthwhile to talk to your primary care doctor or see a urologist.”

Clinical trials have led to the development and approval of several new immunotherapy treatments. “The challenge is we do not have any good biomarkers to tell us how our patients will respond,” Dr. Sundi said. “My lab is developing an assay [test] to non-invasively make an assessment. We’ve learned that if we look at the immune cells in the urine of someone with bladder cancer, they are similar to the immune cells in their tumor … And this could lead to significantly improving the therapeutic options and helping doctors pick the best medicine for their patients from the start.”

Dr. Sundi said his research is motivated by his patients. “When I started in this field the experiences of patients with bladder cancer was something we could and should improve,” he said. “Working toward this is the fuel that is self-sustaining and there is so much excitement in terms of the innovation happening in the bladder-cancer field.”