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Light microscopy of the internal lining of the urinary bladder; haematoxylin and eosin stain
Managing High-Risk NMIBC

Cystectomy versus bladder-sparing treatments

Last updated: 2nd Dec 2025
Published: 2nd Dec 2025

After listening to this podcast, are you more confident in discussing cystectomy and bladder-sparing treatment options with patients with NMIBC?

Episode 12. James Catto, patient Doug Cappiello, and caregiver Camille Cappiello join Ashish Kamat to navigate the toughest decision in NMIBC – cystectomy or bladder-sparing therapy. They consider how clinicians balance cancer control with quality of life, why early risk discussions matter, and practical tips for preparing patients for surgery. The panel examines CISTO study insights on patient-reported outcomes and the caregiver’s role in shared decision-making, while Doug offers candid advice on addressing fears around surgery and navigating recovery. View transcript.

Chapters
00:38 Balancing radical and conservative care
03:55 Helping patients understand risks
05:13 Preparing patients for cystectomy
08:00 CISTO: What clinicians should know
13:57 Caregivers’ role in therapy decisions
17:10 Counseling patients on cystectomy
20:52 healthcare professionals

 

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Meet the guest speakers

James Catto, MD, MB, ChB, PhD, FRCSJames Catto, MD, MB, ChB, PhD, FRCS

James Catto is a leading urological surgeon and former NIHR Research Professor based in the UK. Catto’s research spans all disease stages, from bench to bedside, and includes leadership of multiple phase 2 and 3 trials testing novel oncologic approaches. He served as an editor of a leading surgical specialty journal for a decade, and his work has been cited in over 70 national and international guidelines and government policy documents.

Disclosures: Consultancy fees from Astellas, AstraZeneca, Ferring, Galeas, Janssen, and Pfizer; speaker fees from Astellas, InMed Health, Medac, Merck Sharp & Dohme, and Pfizer; institutional research funding from Roche. Unpaid trustee for Fight Bladder Cancer UK and Weston Park Cancer Charity.

Douglas Cappiello smiling outdoors in front of green foliage.Douglas Cappiello, MD

Doug Cappiello is a retired ophthalmologist and bladder cancer survivor, diagnosed with stage T1 high grade bladder cancer with carcinoma in situ in 2020. Following unsuccessful Bacillus Calmette–Guérin treatment, he underwent robotic radical cystectomy in 2021 and has since made a full recovery. Doug is a patient advocate and survivor-to-survivor volunteer with the Bladder Cancer Advocacy Network (BCAN), serves on its Board of Directors, and founded an online support group for patients.

Disclosures: No disclosures provided at time of publishing.

Camille Cappiello smiling, wearing glasses, with a colorful background. Camille Cappiello

Camille Cappiello is a retired registered nurse and caregiver advocate in the bladder cancer community. She supported her husband Doug through his diagnosis and treatment. Since then, she has served as a patient advocate and survivor-to-survivor volunteer with BCAN, supporting caregivers navigating complex challenges. Camille is passionate about education and peer support, and co-leads an online bladder cancer support group with Doug.

Disclosures: No disclosures provided at time of publishing.

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