One of the most common dilemmas in urologic oncology: what do you do when a patient has T1 disease in both the bladder and the ureter? In the final episode of the 2025 NMIBC Creator Weekend™ series, Dr. Vignesh Packiam, Dr. Mark Tyson and Dr. Sarah Psutka share how they approach complex bladder cancer cases with upper tract involvement.

---

This podcast is supported by:

Ferring Pharmaceuticals
https://ad.doubleclick.net/ddm/trackclk/N2165306.5658203BACKTABLE/B33008413.420220578;dc_trk_aid=612466359;dc_trk_cid=234162109;dc_lat=;dc_rdid=;tag_for_child_directed_treatment=;tfua=;gdpr=${GDPR};gdpr_consent=${GDPR_CONSENT_755};gpp=${GPP_STRING_755};gpp_sid=${GPP_SID};ltd=;dc_tdv=1

---

SYNPOSIS

The doctors discuss complex bladder cancer cases, sequencing treatments for patients with dual ureteral and bladder T1 disease, the impact of cystectomy on quality of life, and the use of blue light cystoscopy and intravesical therapy. They also delve into the rise of bladder cancer in younger patients, considerations for low-grade intermediate-risk disease, and emerging therapeutic options.

---

TIMESTAMPS

00:00 - Introduction
05:52 - Upper Tract Positive Cytology Dilemma
09:10 - Cystectomy Considerations
15:55 - Developing Better Patient-Reported Outcomes
20:26 - Challenges with New Therapeutics
26:31 - Deescalating Treatment for Low-Grade Cancer
33:29 - Closing Remarks

---

RESOURCES

CISTO Trial
https://pubmed.ncbi.nlm.nih.gov/37980511/

Ep. 277 NMIBC Tumor Board: Upper Tract Challenges with Dr. Mark Tyson and Dr. Sarah Psutka