Personalized Approach to Bladder Cancer Treatment in Young Patients: A Clinical Case, Challenges, and the Importance of Communication
https://doi.org/10.62546/3034-1477-2024-2-4-27-34
Abstract
Bladder cancer is one of the most common malignant tumors of the urinary system, with global annual incidence rates exceeding 573,000 cases and a mortality rate of approximately 212,000. In recent years, there has been an increase in the incidence among young adults (under 40 years of age), accounting for 5–10% of all diagnosed cancer cases. In this group, the disease often progresses aggressively due to late diagnosis, and patients face long-term consequences of specialized treatment, including impaired fertility and reduced quality of life. The article presents a clinical case of treating localized bladder cancer in a young patient, discussing the challenges of diagnosis, treatment selection, and long-term follow-up, while emphasizing the need for a personalized approach.
About the Authors
A. D. Murskikh
St. Petersburg State Budgetary Healthcare Institution Clinical Hospital of St. Luke
Russian Federation
Russian Federation
Murskikh Alexei Dmitrievich
Chugunnaya st., 46; St. Petersburg, 194044, Russia
E. M. Anokhina
St. Petersburg State Budgetary Healthcare Institution Clinical Hospital of St. Luke
Russian Federation
Russian Federation
Ekaterina M. Anokhina
Chugunnaya st., 46; St. Petersburg, 194044, Russia
K. E. Chernov
St. Petersburg State Budgetary Healthcare Institution Clinical Hospital of St. Luke
Russian Federation
Russian Federation
Kirill E. Chernov
Chugunnaya st., 46; St. Petersburg, 194044, Russia
R. O. Hrushevsky
St. Petersburg State Budgetary Healthcare Institution Clinical Hospital of St. Luke
Russian Federation
Russian Federation
Roman O. Hrushevsky
Chugunnaya st., 46; St. Petersburg, 194044, Russia
S. V. Popov
St. Petersburg State Budgetary Healthcare Institution Clinical Hospital of St. Luke
Russian Federation
Russian Federation
Sergey V. Popov
Chugunnaya st., 46; St. Petersburg, 194044, Russia
References
1. Bray F. et al. Global Cancer Statistics 2022: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries // CA: A Cancer Journal for Clinicians. 2024. Vol. 74, No. 3, Wiley-Blackwell, Apr. 2024. Р. 229–263. https://doi.org/10.3322/caac.21834.
2. Siegel R.L. et al. Cancer Statistics, 2023 // CA: A Cancer Journal for Clinicians. 2023. Vol. 73, No. 1. Р. 17–48. https://doi.org/10.3322/caac.21763.
3. Каприн А.Д., Старинский В.В., Шахзадова А.О. Злокачественные новообразования в России в 2021 году. Заболеваемость и смертность. М., 2022.
4. Burger M. et al. Epidemiology and Risk Factors of Urothelial Bladder Cancer // European Urology. 2013. Vol. 63, No. 2. Р. 234–241, https://doi.org/10.1016/j.eururo.2012.07.033.
5. Antoni S. et al. Bladder Cancer Incidence and Mortality: A Global Overview and Recent Trends // European Urology. Vol. 71, No. 1, Jan. 2017. Р. 96–108. https://doi.org/10.1016/j.eururo.2016.06.010.
6. Knowles M.A., Carolyn D.Н. Molecular Biology of Bladder Cancer: New Insights into Pathogenesis and Clinical Diversity // Nature Reviews Cancer. Vol. 15, No. 1, Dec. 2014. Р. 25–41. https://doi.org/10.1038/nrc3817.
7. The Cancer Genome Atlas Research Network. Comprehensive Molecular Characterization of Urothelial Bladder Carcinoma // Nature. Vol. 507, No. 7492, Jan. 2014. Р. 315–322, https://doi.org/10.1038/nature12965.
8. Wu Xue-Ru. Urothelial Tumorigenesis: A Tale of Divergent Pathways // Nature Reviews Cancer. Vol. 5, No. 9, Aug. 2005. Р.713–725. https://doi.org/10.1038/nrc1697. Accessed 22 Nov. 2019.
9. Jones P.A., Laird P.W. Cancer-Epigenetics Comes of Age // Nature Genetics. Vol. 21, No. 2, Feb. 1999. Р. 163–167. https://doi.org/10.1038/5947.
10. Choi W. et al. Identification of Distinct Basal and Luminal Subtypes of Muscle-Invasive Bladder Cancer with Different Sensitivities to Frontline Chemotherapy // Cancer Cell. Vol. 25, No. 2, Feb. 2014. Р. 152–165. https://doi.org/10.1016/j.ccr.2014.01.009.
11. Alhubaishy B. et al. Primary Urothelial Bladder Cancer in a Young Patient: A Case Report and Review of the Literature // Cureus. 2021. Vol. 13, No. 6. https://doi.org/10.7759/cureus.15864. Accessed 19 Mar. 2022.
12. Khan R. et al. Bladder Cancer in a Young Patient: Undiscovered Risk Factors // Oncology Letters. Vol. 11, No. 5, Mar. 2016. Р. 3202–3204. https://doi.org/10.3892/ol.2016.4355. Accessed 23 Jan. 2020.
13. Singh P. et al. Comparative Analysis of Clinicopathologic Characteristics and Outcomes of Urothelial Bladder Cancer between Young and Older Adults — Experience from a Tertiary Care Center // Indian Journal of Surgical Oncology. Vol. 15, No. 3, May 2024. Р. 563–71. https://doi.org/10.1007/s13193-024-01950-w. Accessed 3 Mar. 2025.
14. Rouprêt M. et al. Microsatellite Instability as Predictor of Survival in Patients with Invasive Upper Urinary Tract Transitional Cell Carcinoma // Urology. 2005. Vol. 65, No. 6, Elsevier BV. Р. 1233–1237. https://doi.org/10.1016/j.urology.2005.01.019. Accessed 23 Jan. 2024.
15. Nassour A.-J. et al. Relative Risk of Bladder and Kidney Cancer in Lynch Syndrome: Systematic Review and Meta-Analysis // Cancers. 2023. Vol. 15, No. 2. Р. 506. https://doi.org/10.3390/cancers15020506.
16. Leoni Ch. et al. Prevalence of Bladder Cancer in Costello Syndrome: New Insights to Drive Clinical Decision‐Making // Clinical Genetics. Vol. 101, No. 4, 17 Feb. 2022. Р. 454–458. https://doi.org/10.1111/cge.14111. Accessed 24 Mar. 2025.
17. Andreou A. et al. Early-Onset Low-Grade Papillary Carcinoma of the Bladder Associated with Apert Syndrome and a Germline FGFR2 Mutation (Pro253Arg) // American Journal of Medical Genetics. Part A. 2026. Vol. 140, No. 20. Р. 2245–2247. pubmed.ncbi.nlm.nih.gov/16969861/. https://doi.org/10.1002/ajmg.a.31430. Accessed 10 Mar. 2022.
18. Elshabrawy A. et al. Correlates of Refusal of Radical Cystectomy in Patients with Muscle-Invasive Bladder Cancer // Urologic Oncology Seminars and Original Investigations. 2021. Vol. 39, No. 4, 9 Jan. Р. 236.e9–236.e20. https://doi.org/10.1016/j.urolonc.2020.11.023. Accessed 24 Mar. 2025.
19. Vrijland W.W. et al. Abdominal Adhesions: Intestinal Obstruction, Pain, and Infertility. 2003. Vol. 17, No. 7, 14. Р. 1017–1022. https://doi.org/10.1007/s00464-002-9208-9. Accessed 4 June 2023.
20. Holmsten K. et al. Implications for Efficacy and Safety of Total Dose and Dose-Intensity of Neoadjuvant Gemcitabine-Cisplatin in Muscle-Invasive Bladder Cancer: Three-Week versus Four-Week Regimen // Bladder Cancer. 2021. Vol. 8, No. 1, 24 Dec. Р. 71–80. https://doi.org/10.3233/blc-211556. Accessed 27 Dec. 2024.
21. Bajorin D.F. et al. Adjuvant Nivolumab versus Placebo in Muscle-Invasive Urothelial Carcinoma // The New England Journal of Medicine. 2021. Vol. 384, No. 22, 3. Р. 2102–2114, pubmed.ncbi.nlm.nih.gov/34077643/, https://doi.org/10.1056/NEJMoa2034442.
22. Levinson W. Physician-Patient Communicationthe Relationship with Malpractice Claims among Primary Care Physicians and Surgeons // JAMA: The Journal of the American Medical Association. 1997. Vol. 277, No. 7, 19 Feb. Р. 553. https://doi.org/10.1001/jama.1997.03540310051034.
Review
For citations:
Murskikh A.D., Anokhina E.M., Chernov K.E., Hrushevsky R.O., Popov S.V. Personalized Approach to Bladder Cancer Treatment in Young Patients: A Clinical Case, Challenges, and the Importance of Communication. Clinical Case in Oncology. 2024;2(4):27-34. (In Russ.) https://doi.org/10.62546/3034-1477-2024-2-4-27-34
Views:
70
Email this article 