A study to assess the quality of life among patients with high grade non-muscle invasive carcinoma urinary bladder receiving immunotherapy


  • Manish Kumar Department of Surgery, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
  • Gurpreet Singh Bhangu Department of Surgery, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
  • Darpan Bansal Department of Surgery, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India




Quality of life, High-grade NMIBC patients, BCG, Immunotherapy


Background: Urinary bladder lesions are a great health concern as it lies among the top ten most common cancers in the world. These range from benign, harmless lesions that do not recur to life-threatening tumors. The present study was undertaken to assess the quality of life among patients with high-grade non-muscle invasive carcinoma of the urinary bladder receiving immunotherapy.

Methods: A hospital-based experimental study was conducted in the Department of General Surgery of Sri Guru Ramdas Institute of Medical Sciences and Research, Amritsar from April 2021 to July 2022. To examine the Quality of Life of 60 patients before and after immunotherapy, the WHOQOL-BREF tool was employed. The participants were followed for a total of six months, with two follow-ups carried out at intervals of three months each.

Results: The pre-test physical scores (20.70±8.66) were substantially lower than the other domains. At three and six months, the psychological scores were 21.93±8.51 and 49.37±12.27 respectively, while social scores were 23.93±12.16 and 49.15±24.09 correspondingly. Environment scores (p=0.45) showed no significant difference between groups after BCG treatment.

Conclusions: It was vivid that the negative effects of NMIBC on QOL are most pronounced in the physical realm. Quality of life for those with high-grade NMIBC who had BCG treatment improved significantly across all dimensions except the environment. The quality of life of high-grade NMIBC patients was not affected by any of the socio-demographic characteristics except for education and occupational status.


Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424.

Mori K, Mostafaei H, Abufaraj M, Yang L, Egawa S, Shariat SF. Smoking and bladder cancer: review of the recent literature. Curr Opin Urol. 2020;30(5):720-5.

Witjes JA, Compérat E, Cowan NC, De Santis M, Gakis G, Lebret T, et al. European Association of Urology. EAU guidelines on muscle-invasive and metastatic bladder cancer: summary of the 2013 guidelines. Eur Urol. 2014;65(4):778-92.

Babjuk M, Burger M, Compérat EM, Gontero P, Mostafid AH, Palou J, et al. European Association of Urology Guidelines on Non-muscle-invasive Bladder Cancer (TaT1 and Carcinoma In Situ) - 2019 Update. Eur Urol. 2019;76(5):639-57.

Rayn KN, Hale GR, Grave GP, Agarwal PK. New therapies in nonmuscle invasive bladder cancer treatment. Indian J Urol. 2018;34(1):11-9.

Brown TM, Cueto M, Fee E. The World Health Organization and the transition from "international" to "global" public health. Am J Public Health. 2006; 96(1):62-72.

Leary A, Le Tourneau C, Varga A, Sablin MP, Gomez-Roca C, Guilbaud N, et al. Phase I dose-escalation study of F14512, a polyamine-vectorized topoisomerase II inhibitor, in patients with platinum-refractory or resistant ovarian cancer. Invest New Drugs. 2019;37(4):693-701.

Prakash G, Pal M, Odaiyappan K, Shinde R, Mishra J, Jalde D, et al. Bladder cancer demographics and outcome data from 2013 at a tertiary cancer hospital in India. Indian J Cancer. 2019;56(1):54-8.

Fung C, Pandya C, Guancial E, Noyes K, Sahasrabudhe DM, Messing EM, et al. Impact of bladder cancer on health related quality of life in 1,476 older Americans: a cross-sectional study. J Urol. 2014; 192(3):690-5.

Bohle A, Balck F, von Weitersheim J, Jocham D. The quality of life during intravesical bacillus Calmette-Guerin therapy. J Urol. 1996;155(4):1221-6.

Siracusano S, Silvestri T, Bassi S, Porcaro AB, Cerruto MA, Talamini R, et al. Health-related quality of life after BCG or MMC induction for non-muscle invasive bladder cancer. Can J Urol. 2018;25(5):9480-5.

Vaioulis A, Singer S, Ziegler C, Schwalenberg T, Hinz A, Götze H, et al. Quality of life in patients with muscle invasive and non-muscle invasive bladder cancer. Support Care Cancer. 2013;21(5):1383-93.

Yu EY, Nekeman D, Billingham LJ, James ND, Cheng KK, Bryan RT, et al. Health-related quality of life around the time of diagnosis in patients with bladder cancer. BJU Int. 2019;124(6):984-91.

Chung J, Kulkarni GS, Bender J, Breau RH, Guttman D, Maganti M, et al. Modifiable lifestyle behaviours impact the health-related quality of life of bladder cancer survivors. BJU Int. 2020;125(6):836-42.






Original Research Articles