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

First-line treatment: A patient-tailored path

Last updated: 13th Oct 2025
Published: 8th Sep 2025

After listening to this podcast, are you more confident in selecting first-line treatment strategies and integrating multidisciplinary care early in the management of NMIBC?

Episode 4. How do you help older, frailer patients tolerate BCG therapy? When radical cystectomy is the recommended treatment, how can we best support patients in making that decision? Ashish Kamat and Fred Witjes address these questions by sharing practical strategies for dosing, preparation, and patient support, and explore how timely surgery in patients with high-risk NMIBC can reduce disease progression and long-term burden. Witjes also reveals his top tip for reassuring patients about life after cystectomy, and the pair examine how emerging therapies, from gemcitabine–docetaxel to device-assisted chemotherapy, are reshaping care pathways across different healthcare systems. View transcript.

Chapters
00:00 Welcome and introductions
00:35 When to use post-TURBT chemotherapy
04:09 Who benefits from BCG therapy?
06:50 Making the most of BCG therapy
10:13 Managing BCG-unresponsive disease
14:46 Preparing patients for cystectomy
17:50 Wrap-up

 

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Meet the guest speaker

Fred Witjes Fred Witjes, MD, PhD

Fred Witjes is a Professor of Oncological Urology at Radboud University Medical Center, Nijmegen, Netherlands. He specializes in cancers of the bladder, prostate, kidney, and testicle, and leads research integrating clinical diagnostics with surgical, immunotherapeutic, and chemotherapeutic approaches.

Disclosures: Advisor and lecturer for CAPS, Combat, JeMedis, Thermosome, (2024); Medac, Photocure (2025).

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