May is Bladder Cancer Awareness Month, a time dedicated to raising global awareness about one of the most common and impactful urological cancers. It offers an important opportunity to reflect on advances in detection, treatment, and care, especially as new technologies reshape how clinicians approach therapy. Among these technologies, artificial intelligence (AI) is becoming a vital component in the planning and delivery of bladder cancer radiotherapy, bringing a new level of consistency and precision to treatment strategies.
Understanding Bladder Cancer: Key Facts and Figures
Bladder cancer is the tenth most common cancer worldwide, with over 600,000 new cases and approximately 220,000 deaths annually [1]. The disease is significantly more common in men than women and primarily affects older individuals, with most diagnoses occurring in people aged 65 and older.
There are two main categories of bladder cancer based on how far the cancer has spread. Non-muscle-invasive bladder cancer (NMIBC) remains confined to the inner lining of the bladder and is often managed with local treatments. Muscle-invasive bladder cancer (MIBC) penetrates deeper into the bladder wall and generally requires more intensive therapy.
Smoking remains the leading risk factor, accounting for about half of all cases [2]. Occupational exposure to certain industrial chemicals, such as aromatic amines, also contributes significantly.
Early symptoms, including blood in the urine (hematuria), can be easy to overlook, making early detection challenging in some cases. Prompt and accurate diagnosis is essential for effective management and long-term survival.
Treatment Options for Bladder Cancer
Bladder cancer is approached with a range of treatment modalities, depending on the type, stage, and individual patient factors:
- Surgery remains a cornerstone, particularly in early-stage disease or for cystectomy (removal of the bladder) in MIBC.
- Intravesical therapy, often using Bacillus Calmette-Guérin (BCG), is common in NMIBC.
- Chemotherapy, either neoadjuvant or adjuvant, is typically used in advanced stages or alongside surgery.
- Immunotherapy, especially immune checkpoint inhibitors, has become increasingly important in advanced and recurrent cases [3].
In addition to these, radiotherapy plays a crucial role, particularly for patients seeking bladder-preserving options or those ineligible for surgery. It is increasingly being integrated into multi-modality approaches.
Radiotherapy for Bladder Cancer: A Precision-Based Approach
Radiotherapy is a key component in the management of MIBC, especially within bladder-preservation protocols. In these regimens, radiation is combined with chemotherapy with the goal of controlling the disease while avoiding bladder removal. However, bladder motion, daily variation in organ filling, and the bladder’s proximity to surrounding pelvic structures introduce well-documented challenges in radiotherapy planning and delivery. These factors affect dose accuracy and make it more difficult to protect nearby organs-at-risk, such as the bowel, rectum, and reproductive organs [4].
Recent years have seen remarkable innovation in this space. Adaptive radiotherapy, image-guided techniques, and AI-assisted planning are revolutionizing how radiation is delivered. AI contributes to more reproducible and guideline-consistent treatment planning, particularly in anatomically variable sites like the bladder. While certain steps, such as auto-contouring, can be completed more quickly with AI support, overall planning still relies on clinician oversight and quality assurance processes.
As technology evolves, some companies are developing advanced tools to help clinicians manage the complexity of radiotherapy planning.
MVision AI’s Role in Advancing Bladder Cancer Radiotherapy Planning
MVision AI is one such company, providing AI-powered solutions designed to support precision and consistency in radiotherapy planning. Its products, particularly Contour+, assist in the segmentation of organs and anatomical structures that are important for more precise radiation therapy.
Contour+ offers AI-based segmentation models for male and female pelvic radiotherapy treatments. These models support the automatic delineation of regions of interest (ROIs) relevant to bladder cancer treatments, such as the bladder itself, nearby healthy organs (rectum, bowels, cauda equina among others) and regional lymph nodes.
The models are also aligned with international contouring guidelines from leading bodies such as RTOG and ESTRO, supporting consistent and high-quality planning. AI-driven contouring tools help reduce manual variability and enable radiation oncologists to focus more on clinical decision-making.
Beyond contouring, MVision AI’s Dose+ solution, while initially validated for prostate and pelvic lymph node cases, has evolving potential in bladder cancer radiotherapy. It assists in predicting patient-specific dose distributions, aiding clinicians in optimising treatment planning while maintaining clinical quality standards.
By supporting standardisation and improving reproducibility, innovations like these contribute meaningfully to the advancement of bladder cancer care through radiotherapy.
Looking Ahead: The Role of Technology in Treatment
Whether through genomics, immunotherapy, or real-time adaptive radiotherapy, technological innovation continues to reshape clinical care. AI-based platforms, like those developed for radiotherapy planning, help clinicians tailor treatments to individual anatomy and disease characteristics, improving accuracy and potentially leading to better outcomes.
As we observe Bladder Cancer Awareness Month, it is essential to recognize that technology alone is not a solution, but a powerful enabler. When combined with clinical expertise, research, and interdisciplinary collaboration, it becomes a driving force in expanding access to precision oncology. The continued evolution of such tools signals a promising direction for both practitioners and patients.
References
-
- International Agency for Research on Cancer. Bladder Cancer. https://www.iarc.who.int/cancer-type/bladder-cancer
- Cumberbatch, M. G. K., et al. (2023). Epidemiology of Bladder Cancer in 2023: A Systematic Review of Risk Factors. European Urology. https://pubmed.ncbi.nlm.nih.gov/37198015/
- National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Bladder Cancer (Version 2.2024). https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1415. Access requires free registration.
- European Medical Journal (EMJ). Adaptive Radiotherapy for Bladder Cancer – A Review. EMJ Urology. https://www.emjreviews.com/urology/article/adaptive-radiotherapy-for-bladder-cancer-a-review-s180124/
