Instructional Course - Requires Course Pass, Additional Registration Required

Instructional Course

046IC - Trimodality Therapy for Management of Muscle Invasive Bladder Cancer

Sunday, May 20
10:00 AM - 12:00 PM
Location: MCC WEST, 2008

This course is a comprehensive review of tri-modal therapy for muscularis propria invasive urothelial carcinoma of the bladder with a multidisciplinary faculty including urology, radiation oncology, and medical oncology. The course will focus on the Urologist’s critical role in patient selection for this approach vs. radical cystectomy. We will discuss the technique and importance of aggressive transurethral resection and repeat resection prior to proceeding to chemotherapy and radiation, as well as the continued role of the urologist in repeat cystoscopic assessments of tumor response and ongoing surveillance of the bladder. We will review the coordinated multidisciplinary approach for bladder preservation, including radiation fields, role of concurrent chemotherapy, need for early salvage cystectomy when indicated, and management of non-muscle invasive recurrences. We will review potential toxicities and quality of life associated with bladder sparing therapy versus cystectomy, and will address emerging topics such as novel biomarkers and the potential role of combining radiation with immunotherapy and other targeted therapies.

Learning Objectives:

Adam S. Feldman

Massachusetts General Hospital/Harvard Medical School

Dr. Adam S. Feldman is a faculty member of the Department of Urology and a Urologic Oncologist at Massachusetts General Hospital. He completed his residency in urology in 2006 and subsequently completed his fellowship in urologic oncology in June 2008. Dr. Feldman focuses his clinical practice in the treatment of prostate cancer, kidney cancer, bladder cancer and other genitourinary malignancies. He focuses his research interests on translational and clinical research in kidney, prostate and bladder cancers. He has received a Prostate Cancer Foundation Young Investigator Award for his work in novel biomarkers in prostate cancer and has been awarded a Physician Research Training Award by the Department of Defense (DOD). He is a co-PI on a DOD Synergistic Idea Development Award on the development of conditionally reprogrammed cells in prostate cancer, a co-investigator on an National Institutes of Health RO1 on metabolomic imaging in prostate cancer, and PI on a DOD Exploration Hypothesis Development Award investigating metabolomic imaging in renal masses. In addition to his translational research work in genitourinary cancer biomarkers, he has worked to develop clinical databases in active surveillance in prostate cancer, use of imaging and fusion biopsy in prostate cancer, surgical and ablative treatments for renal cell carcinoma, and renal mass biopsy. He is actively involved in the bladder cancer program and MGH and in assessing outcomes for patients with invasive and non-invasive disease.


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Jason Efstathiou

Massachusetts General Hospital

Jason A. Efstathiou, MD, DPhil serves as Associate Professor of Radiation Oncology at Harvard Medical School (HMS) and the Massachusetts General Hospital (MGH). He is the Director of the Genitourinary Division in Radiation Oncology and Clinical Co-Director of The Claire and John Bertucci Center for Genitourinary Cancers Multidisciplinary Clinic at MGH. He holds a B.S. from Yale University, M.D. from (HMS), Ph.D. from University of Oxford, and completed his residency training in the Harvard Radiation Oncology Program. Dr. Efstathiou's clinical practice focuses on treatment of patients with prostate, bladder, testicular and other urologic cancers, as well as proton beam and brachytherapy. His commitment to service/patient care has been recognized as honoree for the MGH Cancer Center's "The One Hundred" and as nominee for the Brian A. McGovern Award for Clinical Excellence. His research has informed clinical practice guidelines and focuses on the effectiveness of advanced/emerging therapies for prostate cancer including proton beam, as well as the adverse effects of hormonal therapy, improving radiation therapy for testicular cancer, and long-term outcomes of bladder-sparing chemoradiation for bladder cancer. He is the recipient of significant grant funding and serves as Principal Investigator of multiple studies including a multi-center randomized phase III trial of IMRT versus proton beam for localized prostate cancer using patient-reported outcomes. He lectures nationally and internationally and holds leadership positions in Radiation Oncology including within the cooperative groups (NRG), professional societies (ASTRO), and National Cancer Institute (NCI). Other projects of his include the development of web-based patient decision aids/support tools, evaluating the multidisciplinary approach to cancer care, and global oncology outreach efforts with Botswana.


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Richard JaeBong Lee

Harvard Medical School and Massachusetts General Hospital Cancer Center

Richard J. Lee, MD, PhD, is a medical oncologist at the Massachusetts General Hospital Cancer Center and Assistant Professor of Medicine at Harvard Medical School, both in Boston. He completed medical and graduate degrees at the Albert Einstein College of Medicine, internal medicine residency at Massachusetts General Hospital, and oncology fellowship training at the Dana-Farber/MGH combined program. Dr. Lee specializes in genitourinary cancers with a focus on biomarker development, cancer cell metabolism, and clinical trials.


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James Rooney

university of massachusetts, worcester, ma

currently in an active general hematology - oncology practice in worcester massachusetts.
i was found to have a T2Nx invasive bladder cancer and reviewed standard treatment options with several consultants at a variety of institutions.
i elected to undergo chemotherapy and radiation under the direction of the MGH group rather than having the standard radical surgical approach.
i remain very pleased with my decision.


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046IC - Trimodality Therapy for Management of Muscle Invasive Bladder Cancer


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