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Our Approach to Multi-Disciplinary Care

Three members of surgical team reviewing a computer screen in operating room.

A Multidisciplinary Team Committed to Each Individual Patient

At the Johns Hopkins Greenberg Bladder Cancer Institute, we practice multi-disciplinary care for every single patient. This means that the entire care team — urologic oncologists, medical oncologists, radiation oncologists, radiologists, pathologists and basic scientists — works closely together to make an accurate diagnosis and develop individualized treatment plans.

Introduction: Johns Hopkins Greenberg Bladder Cancer Institute

The Johns Hopkins Greenberg Bladder Cancer Institute (GBCI) is making a significant impact on bladder cancer treatment, focusing on developing a cure through research. Our multidisciplinary, collaborative clinical approach utilizes innovative strategies - including the genetic sequencing of individual tumors - to provide more treatment choices to patients and help improve outcomes. Advances at the GBCI are having a ripple effect on bladder cancer treatment advances worldwide.


Regular Team Meetings Prevent Care Fragmentation

Team members meet together in the clinic — weekly, though sometimes daily — to review your case: test results, treatment plans, progress, next steps. We believe that collaborative care will help you make the right informed decisions. This team approach allows for all of those caring for you across disciplines can offer their best informed opinion in a one-stop meeting to best review and support the best care options for you moving forward.

You can feel confident knowing that your care team is in sync.

Multi-Disciplinary Clinics Add Convenience

The unique feature of our bladder cancer Multi-Disciplinary program is that patients have the opportunity to be in the same room as the many members of their care team. Our surgical and medical oncologists hold bladder cancer multi-disciplinary clinics on the same day at the same place, and even sit together to review options.

You can consult with both doctors when necessary, and care teams can streamline the scheduling, follow-up and research involved in each treatment plan.

Access to Cutting-Edge Treatments and Techniques and Clinical Trials

As a global hub for advancing the understanding and treatment of bladder cancer, the Greenberg Institute is a leader in the latest research developments. We are eager to share that knowledge.

Our clinicians aren’t just dedicated to patient care — they’re renowned bladder cancer researchers actively working to develop new and better ways to fight the disease. With insight into newly available and on-the-horizon treatments, our team can offer suggestions on the suitability of clinical trial opportunities that may hold promise for many patients.

Tumor Sequencing for Greater Precision

Because bladder cancer treatment can be invasive and have a lifelong impact, it’s vital that individual treatment plans are customized to minimize side effects and maximize outcomes. Because cancer biology dictates clinical behavior and response or resistance to treatment, we need to have a deep understanding of cancer biology to make informed treatment decisions. That’s why at Johns Hopkins, our multidisciplinary approach includes tumor sequencing for every patient.In patients with advanced stage disease that has spread beyond the bladder, tumor sequencing results are a component of standard medical care and their results will be shared and discussed with each patient to collectively decide on optimal therapy approaches.  In early stage patients with disease confined to the bladder, the use of tumor sequencing results to guide therapy has not yet been established as part of standard care.  In such patients, we plan to perform tumor sequencing as part of an ongoing GBCI research effort to identify and understand the key genetic targets responsible for tumor growth, invasion, and spread.  As any results of these research efforts will be preliminary, research tumor sequencing results will be analyzed in a manner in which individual patient identifying information is removed prior to sequencing analyses.  As such, these de-identified tissue sequencing results will not be communicated back to individual patients.

By comparing the tumor’s gene expression patterns and mutations to large public databases of bladder cancer tumors, we can identify the exact cancer type and make predictions about whether certain protocols, like neoadjuvant chemotherapy or radical cystectomy, will ultimately improve outcomes. This unique form of "precision medicine" helps our team assess risk and plan for the most efficient and effective treatments.

Continuity Throughout the Course of Care

Your journey should be as seamless as possible, from diagnosis through treatment and beyond. Consistency and communication are key to reducing unnecessary stress and helping patients heal.

Our oncology-trained nurse practitioner works closely with the multidisciplinary care team to guide you through every step of the process. Patients receiving intravesical chemotherapy or immunotherapy have a dedicated nurse who will administer treatment at every visit. Patients with stomas or neobladders are managed by a dedicated stoma nurse before surgery, during the hospital stay and after discharge. 

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