INTRODUCTION: In Spain, around 20,000 cases of bladder cancer are diagnosed each year. It is the most frequent urothelial tumour and the European country with the highest incidence.
Existence of a training process (empowerment) of individuals and communities may be an excelent intervention resulting in health promotion.
OBJETIVE: To analyze the tolerance and safety of bladder instillations (BI) and the satisfaction value of of both patients and health professionals.
MATERIAL AND METHODS: We conducted a retrospective analysis of the BI in non-muscle invasive bladder cancer (NMIBC) from March 2014 to March 2018. It was divided into two groups: A, patients who were given BI with BCG and MMC; (B),
patients with indication of Hyperthermic Intra-Vesical Chemotherapy (HIVEC) due to their characteristics. Evaluation of the tolerance was held by health proffesionals within group B using the visual analogue scale (VAS) of pain and the development of complications during administration and after the end of treatment.
RESULTS: 311 patients were included. 262 were men (84 %) and 49 women (16 %). Mean age was 69 years (range 37-92). Group A: 202 BCG instillations were made (66%); 32 (10%) of the women and 170 (56%) of the men. 103 (34%) instillations new performed with MMC; 16 women (5%) and 87 (29%) . Group B: Only 6 patients were included in the HIVEC group; 5 men (83%) and 1 women (17%). None intolerability was registered. Untoward effects registered after HIVEC included burning (n=5, 83%), bladder tenesmus (n=4; 67%). Haematuria, fever and urinary incontinence were not registered in any patient whatsoever. One single patient (17%) had cystitis with a positive urine culture. 253 pacients (83%) said tolerability was “good” and 52 (17%) moderate. Pain evaluation distribution measured through VAS was: 0 (n= 180, 59%); 2 (n=80, 26%) and 4 (n=45, 15%). Nursery follow up by telephone had a 100% response rate. Mean satisfaction value was 8 (very unsatisfied: 0; very satisfied: 10)
and the performance to professionals with 9.
CONCLUSIONS: 1. Participation of an expert multidisciplinary team improves the administration and compliance of the adjuvant treatment in NMIBC.
2. The need to include all patients with NMIBC in the internal improvement plan in the MMC and BCG instillation process.
3. Involving patients and their environment in the treatment helps the identification and early resolution of complications as well as compliance with treatment.