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Researcher informs national conversation on improving bladder cancer care

Dr Mohini Varughese

A South West bladder cancer expert has contributed to a podcast exploring why advances in treatment identified through research have been slow to enter clinical practice. 

Dr Mohini Varughese is Cancer Specialty Research Lead for the NIHR Clinical Research Network South West Peninsula and the NIHR’s national Urological Cancer Subspecialty Champion, as well as a Consultant Clinical Oncologist at the Royal Devon & Exeter NHS Foundation Trust. She was invited by the journal Clinical Oncology to take part in the podcast, which has now been released entitled: Bladder Radiotherapy: is Cinderella Ready for the Ball? An expert panel discussion on current challenges and opportunities in bladder cancer.

The podcast was linked to a special edition of the journal focusing on Bladder Radiotherapy, and chaired by its editor, Professor Robert Huddart from the Institute of Cancer Research. The discussion brought together several experts in the treatment of bladder cancer as well as Dr Lydia Makaroff from the charity Fight Bladder Cancer, and covered the issues and controversies surrounding treatment of the disease.  

Dr Varughese authored a chapter in the special edition - Overcoming the chasm between evidence and routine practice for bladder cancer; just a quixotic notion? – and her work highlights the gulf between research, with clinical trials identifying interventions shown to improve outcomes, and routine practice in the NHS. Despite major bladder cancer trials taking place in the UK, and huge expertise in the field here, adoption of new treatments continues to lag behind.

She said: “Continued work is required to understand why benefits seen in clinical trials are not translating into improved outcomes for patients. One reason is likely to be that the average age of patients with non-metastatic muscle invasive bladder cancer is elderly (76), and patients recruited into clinical trials do not necessarily represent those seen on a day to day basis.   

“Ultimately, if we are to improve outcomes we need to develop clinical trials that are relevant to the typical population of patients, who are usually older and often have competing co morbidities, not just the select few who are ‘trial fit’.”