Introduction: Intravesical therapy is the mainstay of treatment for non-muscle invasive bladder cancer (NMIBC). However, patients with NMIBC can face time, travel, and financial barriers to access intravesical therapy which may impact patient adherence to treatment. Therefore, we sought to quantify patient-reported treatment burden while receiving intravesical therapy for bladder cancer. Methods: We conducted a cross-sectional survey of bladder cancer patients in the Bladder Cancer Advocacy Network (BCAN) Patient Survey Network to investigate patient-reported burden of intravesical therapy. Multiple choice survey questions were developed by investigators, then iteratively revised and improved by review from clinician and patient advocate stakeholders during the 2021 BCAN annual meeting. Eligible participants received at least one dose of intravesical therapy, including BCG and/or chemotherapy, delivered in an ambulatory setting. Survey was administered in November 2021 and was available for 1 month to respondents. Results: A total of 233 patients responded to the survey (18% response rate), with a median age of 70 years (range 33-88). Respondents were 36% female and 97% white. A travel time >30 minutes to an intravesical treatment facility was reported by 55% (126/231) of patients, and 33% (77/231) reported personal out-of-pocket costs greater than $25 associated with each trip. Fifty-six percent (129/232) brought caregivers to their appointments. More than half of patients (56%, 129/232) reported spending more than 2 hours on each intravesical instillation, with 18% (42/232) spending more than 4 hours. Missing work for intravesical installations was reported by 36% (82/230) of patients, and of those who did, the majority (70%, 57/81) missed at least half a day of work (4 or more hours). Sixty-one respondents (26%) felt the process of receiving bladder instillations adversely affected their ability to perform regular daily activities. BCG shortages increased travel or wait time for intravesical therapy for 9% (20/229) of respondents. Conclusions: Bladder cancer patients reported considerable travel distances, time requirements, out-of-pocket costs, and need for caregiver support in the process of receiving intravesical therapy. Innovative intravesical care delivery processes are needed to reduce the burden of care for our bladder cancer patients. SOURCE OF Funding: n/a
