The Evolving Treatment Landscape and Patient Perspectives


Drs Jain and Shah discuss the future of patient care in metastatic bladder cancer, while Mr. and Mrs. Ehas share advice for patients with bladder cancer, advice for caregivers and closing thoughts on their overall journey.


Rohit Jain, MD, MPH: So, looking into the future, Dr Shah, which is a difficult question, how do you see the role of oncology pharmacists in this evolving patient care?

Anand Shah, PharmD, BCOP: It is a difficult question, but you just mentioned all of the trials that are ongoing, and honestly, that is the future at least in the next few years. As we can see here … combination therapy is becoming the next more of treatment within oncology. Oncology is getting more complex, but we’re also getting better at taking care of patients. And as things get more complex, team-based approaches make more and more sense. You want pharmacists, oncology pharmacists to specialize in taking care of cancer patients so that you do know these new agents [00:42:00] that are coming out and you do know how to take care of their [adverse] effects, what monitoring is required with these agents. A lot of these new drugs have very unique [adverse] effects. And back in the day when we had just toxic chemotherapy drugs, they had very similar [adverse] effects. Now these agents are very targeted and with targeted drugs come targeted [adverse] effects. So just knowing and being aware of these [adverse] effects, the role of oncology pharmacists is going to grow in the future, honestly as we continue to develop new therapies.

Rohit Jain, MD, MPH: Absolutely. It’s a learning curve for all of us with the new drugs coming, new toxicities. And I think the amazing thing that I look at as a physician is the improving overall survival. I think that’s the most important aspect. As Jeff mentioned, in the first part [of] the first question [that] came up, how long do I have? And that is something that we are striving to improve as much as possible. So, coming towards the closing of our session, Jeff and Lauren, what advice could you share for other patients with bladder cancer? What has been your overall treatment experience?

Jeffrey Ehas: My overall experience, it was terrifying in the beginning. You don’t know what to expect, what’s going on. Am I going to live a week, a month, a year? You don’t know. It’s terrifying. But honestly, Moffitt [Cancer Center] is a great place. Everyone was wonderful, helpful, amazing, intelligent. My advice is, don’t give up hope. There’s always hope. There [are] always new drugs, there’s always new research, there’s always something new out there. And I was very lucky because I got something that was new … avelumab … had just been approved by the FDA. It was just approved. Dr Jain said, “Try this,” and we did. And I’m so happy I did because I’m here today to tell you that there’s always hope. You’ve got to believe there’s always hope, and you got to have a good strong support system and never stop hoping. Hope for the best.

Rohit Jain, MD, MPH: Absolutely agree. Absolutely agree. Lauren, what about you?

Lauren Ehas: I just want to say … just ask the questions. Be organized, be supportive. Don’t live every day like your loved one has cancer. Live every day like it’s a normal day. Enjoy each other, enjoy the days you’re given. Be thankful [for] the blessings that you do have. The access we have to what we have medically is a huge blessing. [00:45:00]

Jeffrey Ehas: Enjoy every day while you can.

Rohit Jain, MD, MPH: I completely agree with you both. I think it’s very important … to have an optimistic view towards the treatment. And if you feel good, then it helps you to tolerate the issues if they come up. But I absolutely agree with you, that hope is the most important part that we need to have and carry forward.

Jeffrey Ehas: Always think positive.

Rohit Jain, MD, MPH: Absolutely. Dr Shah, any other thoughts?

Anand Shah, PharmD, BCOP: I’ll just share one more thing. You guys have a great support system, but … if you do or you don’t, always make sure that you rely on your providers for the support as well. We tell our patients that we’re starting a new therapy for you, but that doesn’t mean that we’re going to give you this drug and say bye, don’t talk to us. We’re starting something for you, but it’s a journey for us as well. So just reach out to us. If you’re experiencing [adverse] effects, that open line of communication helps a lot. Like you experienced that infusion reaction, we were able to take care of that issue and you were able to continue the drug for a long time, and the reason why you were able to do that was because of communication. So … that’s one piece of advice that I would give the patients is that if you are experiencing [adverse] effects, reach out to your providers, and more often than not, we would be able to help manage that [adverse] effect.

Jeffrey Ehas: We’re a team, we’ve got to work with each other.

Anand Shah, PharmD, BCOP: Exactly.

Rohit Jain, MD, MPH: Absolutely. It’s all a team effort. It’s the physician, the nurse practitioners, the pharmacists, and the nurses who take the phone calls and triage appropriately. I think it’s all the combination.

Anand Shah, PharmD, BCOP: Absolutely.

Rohit Jain, MD, MPH: Well, we’re at the end, I really appreciate all of your time. Thank you to Jeff, Lauren, and Dr Shah for joining us in this discussion on bladder cancer, which is brought to you by Cancer Network. And thank you to our audience. We hope you find this interactive discussion to be informative and beneficial to your clinical practice. I appreciate all of your time. Thank you so much.

Jeffrey Ehas: Thank you.

Anand Shah, PharmD, BCOP: Thank you.

Transcript is AI-generated and edited for clarity and readability.

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