Advances in Bladder Cancer Research and Treatment

Dr. Nimira Alimohamed is a medical oncologist at the Tom Baker Cancer Centre and clinical associate professor in the department of medicine at the University of Calgary. She shares a decade of insights, including novel and Alberta-made bladder cancer treatments and research.

By: Sean P. Young

Illustration by Dane Thibeault.

Bladder cancer is the fifth most common type of cancer in Canada, yet it “has received less attention [than other cancers] in the media,” says Dr. Nimira Alimohamed. “That being said, outcomes for patients are improving and patients with bladder cancer can live a long time.” 

Alimohamed specializes in researching and treating muscle-invasive bladder cancer and advanced bladder cancer, which usually means the disease has progressed beyond stage 1 and patients need aggressive treatment. Muscle-invasive bladder cancer is typically, though not always, treated by the removal of the bladder and neoadjuvant chemotherapy — that means the chemotherapy is given to the patient before surgery. “Both non-muscle-invasive and muscle-invasive stages of the disease are potentially curable,” Alimohamed says. 

Here, Alimohamed shares several promising advancements that offer hope for Albertans facing bladder cancer.

Q: What are the symptoms to look for that may indicate bladder cancer?

“The most common symptom of bladder cancer is blood in the urine. If a patient has blood in the urine, they really should see their doctor quickly. Oftentimes, women are delayed in terms of getting a diagnosis of bladder cancer because, if a woman presents with blood in the urine, it’s often [presumed to be of] gynecological origin, as opposed to starting in the urinary tract. So something to keep in mind, as well, is that both men and women can get bladder cancer.”

Q: Why did you decide to focus on researching and treating bladder cancer?

“Between 2010 and 2014, while I was doing my medical oncology training, there were a lot of advancements in kidney cancer and in prostate cancer — the field was changing very quickly. But I realized there was a huge unmet need in the [bladder cancer] patient population.” 

Q: How has treatment advanced since you started working in the bladder cancer space nearly a decade ago?

“We’ve seen a lot of advancements. The introduction of immunotherapy has really changed what we do. Pembrolizumab is an immunotherapy drug that became available in 2018 only to patients with advanced bladder cancer. Immunotherapy has now moved into maintaining remission with another immunotherapy drug, Avelumab. If those medications stop working, we now have another option, which is an antibody drug conjugate [targeted biopharmaceuticals intended to kill cancer cells while sparing healthy cells]. We also have targeted therapy for some patients. These are all options that we did not have 10 years ago. It’s rapidly evolving in a good, meaningful way for patients in terms of improving their outcomes.”

Q: What advantages do Albertans facing bladder cancer have when it comes to the research and treatment options available here?

“A few years ago, I was lucky enough to work with the PaCER [Patient and Community Engagement Research] group at the University of Calgary. We really wanted to hear the patients’ voices as they were on their journey with bladder cancer. We’re currently working on that research by taking exactly what the patients told us and trying to improve on our system so that patients throughout the province have standardized care. Our goal is that patients understand their disease, they understand their treatment options and they receive the right care at the right time. 

“Over the last several years, we’ve had a multitude of clinical trials here in Alberta for our patients, which means that they have access to novel therapies before they become the standard of care. Our patients are also contributing to advancements in the field. Bladder cancer patients in Alberta now have improved quality and quantity of life.”

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