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

Recurrence and support in NMIBC care

Last updated: 14th Nov 2025
Published: 14th Nov 2025

After listening to this podcast, are you more confident in supporting patients with NMIBC through recurrence and addressing their psychological needs?

Episode 11. Ashish Kamat, Alison Birtle, and patient Melanie Costin discuss how the language used during consultations, particularly in the earliest stages of care, can shape patient understanding and emotional response, especially when addressing sensitive topics like recurrence. They explore the psychological impact of treatment, the importance of recognizing patient priorities, and how clinicians can support quality of life through shared decision-making and honest conversations about the implications of treatment choices. This three-way discussion also highlights the role of support systems in helping patients navigate care. “We should use patient support groups as a supplement and complement to the discussion we have with patients,” concludes Kamat. View transcript.

Chapters
00:00 Welcome and introductions
00:33 Making sense of recurrence
01:41 How do you talk about recurrence?
05:16 Navigating difficult treatment decisions
09:01 What do patients want to hear first?
11:57 Side effects and silent struggles
14:18 Talking through treatment shifts
16:57 Explaining care pathways
20:36 How do patients choose care?
25:33 What support systems exist?
28:40 Wrap-up

 

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Meet the guest speakers

Alison Birtle, FRCP, FRCR, MD, DipLCMAlison Birtle, FRCP, FRCR, MD, DipLCM

Alison Birtle is a Consultant Clinical Oncologist, MAHSC Honorary Clinical Professor in the Faculty of Biology, Medicine & Health at the University of Manchester, and Honorary Clinical Professor at The University of Central Lancashire, UK. She specializes in urologic cancers and has been Chief Investigator on multiple clinical trials, including the POUT trial, now part of European Urology Guidelines. She serves as trustee and medical advisor to Fight Bladder Cancer, advisor to Macmillan, and Secretary of the British Uro-oncology Group.

Disclosures: Speaker fees/travel support from Accord, Bayer, Janssen, MSD, Pfizer, and Roche. Consulting services for AstraZeneca, Johnson & Johnson, Macrogenics, Merck, and MSD. Advisory board member for Accelerated Applications, Accord, Astellas, AstraZeneca, Bayer, Bristol Myers Squibb, Gilead, Janssen, Merck, MSD, Novartis, Pfizer, and Roche. Member of the European Association of Urology (EAU) Guidelines Group for NMIBC and UTUC. Secretary of the British Uro-oncology Group. Medical Advisor and Trustee for Fight Bladder Cancer. Advisor to Macmillan on patient information. Faculty member of the European Society of Medical Oncology (ESMO) Education Program.

Melanie CostinMelanie Costin

Melanie Costin is a bladder cancer patient and Director of Patient Engagement & Support at Fight Bladder Cancer. Drawing on her lived experience, Melanie ensures the voices of those affected by bladder cancer are represented in research, policy, and clinical practice. She is a Patient Expert for the EAU and volunteers with the World Bladder Cancer Patient Coalition, contributing to education and international health policy.

Disclosures: No relevant disclosures.

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