In this conversation, moderated by Ashish Kamat, Paulo Gontero and Gary Steinberg, discuss the treatment and management of intermediate risk, non-muscle invasive bladder cancer (NMIBC). Gontero explains their use of the 2021 EAU guidelines to determine a patient's risk category based on several variables. He emphasizes the complexity of the intermediate risk category and the further need to sub-stratify patients. Gontero and Steinberg discuss treatment approaches, from intravesical therapy to active surveillance. Steinberg advocates for more office-based treatments to avoid operating room visits. They also debate the appropriate use of active surveillance, agreeing it is not suitable for high-grade cases. Surveillance strategies are highlighted, from cystoscopies to ultrasounds, along with the importance of patients’ adherence to long-term follow-up. Lastly, they discuss the implications of their findings for future clinical trials and the need to improve patient’s quality of life.

Biographies:

Paolo Gontero, MD, Professor of Urology, Chair, Department of Urology, University of Torino School of Medicine, Molinette Hospital, Torino, Italy

Gary Steinberg, MD, Professor and Director of the Goldstein Urology Bladder Cancer Program, NYU Langone Health, New York, NY

Ashish Kamat, MD, MBBS, Professor, Department of Urology, Division of Surgery, University of Texas MD Anderson Cancer Center, President, International Bladder Cancer Group (IBCG), Houston, Texas