Frances M. Alba, MD, presented “Recurrent T1HG Bladder cancer after BCG: More Intravesical Therapy or Radical Cystectomy” at the 28th Annual Innovations in Urologic Practice conference on September 20, 2024.
How to cite: Alba, Frances M. “Recurrent T1HG Bladder cancer after BCG: More Intravesical Therapy or Radical Cystectomy.” September 2024. Accessed Nov 2024. https://recurrent-t1hg-bladder-cancer-after-bcg-more-intravesical-therapy-or-radical-cystectomy/
Recurrent T1HG Bladder cancer after BCG: More Intravesical Therapy or Radical Cystectomy – Summary
Frances M. Alba, MD, discusses the management of T1 high-grade bladder cancer, focusing on cases that recur following BCG therapy.
In this 14-minute talk, Dr. Alba introduces the case of a 53-year-old male with T1 high-grade bladder cancer who underwent a complete six-week BCG course but experienced recurrence within ten weeks. Dr. Alba notes that BCG failure is not uncommon, with the term “BCG unresponsive” now used to describe persistent or recurrent disease within defined timeframes after adequate BCG treatment. In these patients, continued BCG is seldom effective.
Alba highlights the AUA guidelines for these patients, recommending cystectomy as the best chance to prevent disease progression. Despite its efficacy, only a quarter of urologists in the US recommend cystectomy for BCG-unresponsive cases, with many preferring intravesical chemotherapy. Gemcitabine-docetaxel combination therapy shows promise. Alba also shares additional options, such as nadofaragine, pembrolizumab, and novel therapies, including N-803.
About The 28th Annual Innovations in Urologic Practice:
Presented by co-chairs Mohit Khera, MD, MBA, MPH, and Michael Coburn, MD, FACS, the Innovations in Urologic Practice conference provides a detailed review and commentary on multiple genitourinary and urologic diseases. Among the featured oncological topics are bladder cancer and immunotherapies, as well as upper tract cancer management, prostate cancer, including state-of-the-art imaging, focal therapy, and MRI. Experts also discuss new tools and techniques for nephrectomy and treating advanced renal cell carcinoma. In terms of general urological approaches, the conference also includes pelvic reconstruction and trauma; men’s health topics like male infertility, andrology, and sexual dysfunction; OAB and voiding dysfunctions; and ways to diagnose and treat infections in the urology patient.
For further educational activities from this conference, visit our collection page.
ABOUT THE AUTHOR
Frances M. Alba, MD, is an associate professor in the Department of Surgery, Division of Urology at the University of New Mexico’s (UNM) Health Sciences Center in Albuquerque. Dr. Alba is also the Urology Residency Program Director at UNM. Dr. Alba earned her medical degree from the UNM School of Medicine. She completed her residency at the University of Texas Health Science Center and MD Anderson Cancer Center in Houston, Texas. Dr. Alba completed an internship with a specialty in surgery at the University of Texas Health Science Center at Houston.
Dr. Alba practices at the UNM Hospital, UNM Comprehensive Cancer Center, and at the UNM Sandoval Regional Medical Center. Her clinical interests include kidney, bladder, testicular, and penile cancer. She has contributed to several publications, most recently an October, 2022 paper discussing predictors and barriers to resident scholarly activity in U.S. urology residency programs.
Dr. Alba’s clinical practice interests encompass all aspects of general urology, with a particular expertise in bladder, kidney and testicular cancer. She is committed to providing the highest quality care to her patients and understands the impact of social determinants of health. As a native New Mexican she is skilled in delivering care that is sensitive to the cultural diversity of the population in New Mexico and is honored to care for her community. In addition to developing enduring educational strategies within the Division of Urology, Dr. Alba’s goal is to be a leader in performance improvement for clinical and educational activities within UNM Health.
