OBJECTIVES: Current treatment options for high-risk non-muscle invasive bladder cancer (NMIBC) are associated with high failure rates, high medical costs, and reduced quality of life (QoL). This study evaluated NMIBC burden among patients treated with Bacillus Calmette-Guerin (BCG) to better understand unmet needs.

METHODS: A cross-sectional, internet-based survey assessing patient characteristics, treatment perceptions, and QoL was completed by patients with NMIBC. Patients (aged ≥18) were recruited via physician referral. Providing consent and having concurrent or prior BCG treatment (within ≤3 years) was required; clinical trial participants were excluded. Subgroups were compared via Fisher’s exact tests and t-tests.

RESULTS: Of the 150 patients included (54.7% male, 18.0% Black), median age was 63.0 years. All patients had transurethral resection of bladder tumor, 12.0% received chemotherapy, and patients received BCG a mean of 7.0 times. None received radical cystectomy; 94.0% reported it was very/extremely important to keep their bladder. Patients most often perceived BCG treatment to be painful/uncomfortable (69.3%) or frightening/scary (50.0%). Patient’s top goal for BCG treatment was cancer remission/avoid recurrence (76.0%). Lower scores on EQ-VAS (63.9 vs.70.2) and EORTC QLQ-30 role (51.5 vs. 64.7) and social (57.3 vs. 71.2) functioning were observed among patients treated <1 (vs. ≥1) year ago (all, p<0.05). Most (68.6%) were satisfied overall with BCG treatment, but satisfaction was lower for patients treated <1 year ago, those who experienced side effects, and those who had greater BCG administration discomfort (all, p<0.05).

CONCLUSION: Patients had positive perceptions of BCG efficacy, but satisfaction and QoL were lower among patients who were currently on or completed BGC <1 year. Those who experienced side effects and greater discomfort during BCG administration were also less satisfied. Future NMIBC treatments should focus on delaying or avoiding recurrence and cystectomy, while reducing patient discomfort.