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Transcript of Update: What You Need to Know About COVID Vaccines and Bladder Cancer with Dr. Seth Lerner and Dr. Laila Woc-Colburn

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Voice over:

This is Bladder Cancer Matters, the podcast for bladder cancer, patients, caregivers, advocates, and medical and research professionals. It’s brought to you by the Bladder Cancer Advocacy Network, otherwise known as BCAN. BCAN works to increase public awareness about bladder cancer, advances bladder cancer research, and provides educational and support services for bladder cancer patients and their loved ones. To learn more, please visit bcan.org.

Rick Bangs:

Hi, I’m Rick Bangs, the host of Bladder Cancer Matters, a podcast for, by and about the bladder cancer community. I’m also a survivor of muscle invasive bladder cancer, the proud owner of a 2006 model year neobladder and a patient advocate supporting cancer research at the Bladder Cancer Advocacy Network or as many call it, BCAN, producers of this podcast. This podcast is sponsored by Merck, Bristol-Myers Squibb, and Genentech.

Rick Bangs:

I am pleased to welcome back today’s speakers, Dr. Seth Lerner and Dr. Laila Woc-Colburn to provide a sequel to last year’s podcast on COVID and bladder cancer. Dr. Lerner is a Professor of Urology and holds the Beth and Dave Swalm Chair in Urologic Oncology in the Scott Department of Urology at the Baylor College of Medicine. In addition to being a urologic oncologist, Dr. Lerner is a member of the BCAN board of directors and the BCAN scientific advisory board. He also co-chairs the management committee of the BCAN Bladder Cancer Research Network.

Rick Bangs:

Dr. Laila Woc-Colburn is an attending physician on the Infectious Diseases Consultation Service at Emory University Hospital and Emory University Midtown Hospital. She provides outpatient service at the Emory Healthcare Infectious Diseases Clinic.

Rick Bangs:

In today’s episode, we are going to revisit the challenges of managing bladder cancer during a global pandemic and concerns about the intersection between bladder cancer treatments and COVID. The bladder cancer community, which generally tends to be older adults, faces above average risk of serious and potentially deadly consequences if they contract COVID. We will once again ask, but this time through a 2022 lens, what do bladder cancer patients need to know? Dr. Lerner and Dr. Woc-Colburn, thank you so much for joining me, and welcome back.

Dr. Seth Lerner:

Thanks for having us, Rick, and happy to tackle this topic again with my friend Dr. Woc-Colburn.

Dr. Laila Woc-Colburn:

Thank you for having me again from the Peach State here in Georgia, and happy first spring day.

Rick Bangs:

Thank you. All right. So Dr. Woc-Colburn, I want to start with you as an expert on infectious diseases like COVID. So a lot’s changed about COVID and yet there seems to be a whiff of deja vu in the air versus a year ago. So let’s start with the status of COVID here in the United States. Can you give us kind of a quick snapshot of where we are today?

Dr. Laila Woc-Colburn:

Yeah, so it’s maybe a small deja vu. We’re starting the third year of our pandemic, and we’re start thinking about this becoming more of an endemic virus. More people have acquired it throughout. Last year we went through the Delta wave as well as the Omicron wave, so that’s a little different.

Dr. Laila Woc-Colburn:

We started this year, first of all, in the world passing the six million mark of deaths. Not so bad here in the United States, but we did have some hotspots, especially with the Omicron. So right now all the cases are going down, and the CDC has changed a little bit of how we see our community levels. They reverted back to what we call the traffic light. Green means low community levels, kind of yellow orangey means medium, and then red means high degree of COVID cases. Which means that a lot of the states as well as communities are letting go of the masks, so that’s different from last year.

Dr. Laila Woc-Colburn:

Last year we had areas that were highly contagious and that had a lot of you had to have the mask as well as vaccine mandates. In the United States we’re about 72% vaccinated, fully vaccinated, so that’s also good. We also have another group that has acquired, what we call the asymptomatics who had the disease and then people who actually got the disease. Other things on the news that are news is that we actually have a couple of oral antivirals that we can use. We did not have that last year. We know a little bit better how to treat COVID as an outpatient instead of just inpatient treatment in the hospital.

Rick Bangs:

Okay. So I want to come back to those antivirals because that’s really exciting news. But let’s start with some of the more common and current COVID mitigations. So last year when we talked, the vaccines were literally just rolling out. So a lot has changed just with the vaccinations, right?

Dr. Laila Woc-Colburn:

That is correct. I think there’s been ebbs and flows with vaccines. One thing that probably not everybody know is that there is about 272 candidates out there for vaccines. But not all those 272 candidates actually make it to what we call the second or third phase of clinical trials. Out of those 272, we’re down to about 20, and that’s around the world.

Dr. Laila Woc-Colburn:

In the US we use three main ones or two platforms. The most common platform that we use in the United States is the RNA messenger or the mRNA, which are the Pfizer and Moderna. That’s one type of platform. The second platform is what we call a vector, adenovirus vector, which is the Johnson & Johnson. So those are still the ones here in the United States. We haven’t changed that. In the world there’s other ones that have been used.

Dr. Laila Woc-Colburn:

What we know is that they’re effective. So there was a lot of buzz during the summer about how effective they were against Delta and then how effective they were against Omicron. We also had the famous introduction of having a third shot, we call it a booster, so that also came. So it was kind of a quick pace turnaround, a lot of new things, a lot of new data coming out for people with vaccine, which made it kind of for the general public very difficult to follow and sometimes a little maybe mistrust the system because of how rapidly things were changing. That created a little bit of vaccine hesitancy just because we turned things quickly over a period of a year.

Rick Bangs:

That’s the first I’ve heard of the number of vaccine candidates. That’s really an amazing statistic. So talk about the safety of the mRNA vaccines. That’s Moderna and Pfizer here in the US. Tell us what the data says.

Dr. Laila Woc-Colburn:

There has been a lot of misinformation, right? This misinformation has created a lot of vaccine hesitancy, and the misinformation has stemmed from social media, from groups, from highly publicized people and things like that. So one of the myths with the RNA vaccines, the first ones that came out, is they were going to implant a device or you were going to become like a magnet. So there was a lot of TikToks where people were putting spoons and things like that. Anyway, so that’s a myth. There’s a lot of myths.

Dr. Laila Woc-Colburn:

The other myth was actually that to our audience in BCAN is that they were going to be infertile so that the sperm was not going to be able to do what it’s supposed to do. That came out because of some ACE2 receptors, and they thought that that was going to be, but that was not the case. For women, there is also a receptor that is similar, and so they thought that there could be infertility or cause early miscarriage. That was also debunked. That actually carried a lot of weight. People were afraid that they were going to be sterile or they were not going to be able to conceive.

Dr. Laila Woc-Colburn:

Another myth that got debunked was that it was going to be a way of getting people tracking around or they were not going to get enough immunity against COVID. So what we know is when we saw the Omicron wave as well as the Delta wave, the people that were hospitalized were those that were not vaccinated. It was not unusual to see in our hospitals families or a member of a same family who would end up in the hospital and not all of them making it. So that was during the Delta as well as the Omicron.

Dr. Laila Woc-Colburn:

So the patients that were not vaccinated were most vulnerable of getting severe COVID. So all in all, when we look at the side effects and adverse events that are taken care at the CDC, they’re very minimal that we have seen throughout compared to being able to survive and also not get what we call post-COVID long syndrome, which is sometimes fatigue, kind of an inflammation, just kind of fogginess and things like that. There’s many advantages, but unfortunately there’s also a lot of myths out there.

Rick Bangs:

I think you were reinforcing that the risks of COVID are significantly more than any risk that one would face with a vaccine, right?

Dr. Laila Woc-Colburn:

Correct. Yes.

Rick Bangs:

All right. We have other weapons in the fight against COVID. When we talked last, masks were in pretty short supply, but we’re in a different place on masks in 2022 than we were in 2021, right?

Dr. Laila Woc-Colburn:

Yes. So the supplies are different. Obviously we’re still having issues with supplies for other things in the world. We also know which types of masks to use. We know that the best masks that we can use is an N95. Those are the ones we use as health providers or first responders. Those have to be fitted, and that was also kind of something that CDC came out during the Christmas break.

Dr. Laila Woc-Colburn:

The other ones are what we call the KN95, which give you more protection, and they have to be fitted and you can actually get those through Project KN95. You can get them in Amazon. Actually, you even can get them at your local Lowe’s or Home Depot. Then you have the surgical mask where is the one that is mostly available. Then the cloth masks don’t protect you as well.

Dr. Laila Woc-Colburn:

So for people who are actively on chemo what we ask them, even though they’re vaccinated, is to continue wearing a mask. Even though some places might have calmed down the mask mandate and you don’t have to wear them. Just for protection.

Rick Bangs:

You would be suggesting an N95 or a KN95 mask for people who are undergoing treatment, right?

Dr. Laila Woc-Colburn:

Yes. I would suggest that. The KN95s are more accessible, and you don’t have to have a fit test. Yes.

Rick Bangs:

Right. Okay. Testing is also a lot different than when we had talked before. So a number of people have gotten at-home testing from the government, and they can go to the store and insurance covers it for almost everybody now. So can you talk about testing in 2022?

Dr. Laila Woc-Colburn:

Yes. So as people might have remembered, testing was a big issue during Christmas and the Thanksgiving holiday. So obviously now we have too many tests. So people are able to buy when there was no supply and through the government, you can get two tests and use that.

Dr. Laila Woc-Colburn:

So we have two types of tests. We have an antigen test, which is the home kits that you can get at the different pharmacies or through the mail. Or the other one is a PCR. The difference is that the antigen is a rapid test. It tells us when you’re having the fever, if you have the virus. Well, the PCR is the one that they have to go and sample up your nose and feels kind of funny and it makes you sneeze. That one is more sensitive and that’s picking up little viral particles and tells us where you are in the process.

Rick Bangs:

Okay. Then you mentioned earlier about antivirals, and that to me is a really exciting breakthrough since the last time we talked. So tell us a little bit about … I think there are two drug treatments, two antivirals that are approved in the US … Where are we now on that, including the supply?

Dr. Laila Woc-Colburn:

That’s one of the biggest change from the last two years. So 2020, by this time in March, April, we kind of knew one of the antivirals that might work was a intravenous. Fast forward to 2021, we knew that remdesivir and dexamethasone, which are steroids work really well for moderately to severe patients. So those are the patients that end up in the hospital with saturations that are below 94.

Dr. Laila Woc-Colburn:

The part that we needed to work on was how to prevent the mild or asymptomatic or dose exposed, so postexposure prophylaxis. That’s where the new antivirals come in. So there’s two oral antivirals. One is called Paxlovid that is from Pfizer, and the other one is Molnupiravir, which is from Merck. Paxlovid is an antiviral that uses an antiviral from HIV called ritonavir, and it kind of works similar. You take it, and it gives you 89% efficacy of not progressing to a moderate, severe disease. These are for patients who have mild COVID. So saturation above 94, having symptoms.

Dr. Laila Woc-Colburn:

The molnupiravir, and as a disclosure, this was one of the drugs developed here at Emory through DRIVE. That one gives you an efficacy around 29%, 30%. So not as good as the other one, but the caveat is that it doesn’t have a drug-drug interaction because the other one does. That’s the exciting part. So we have two orals, and when they came out, availability wasn’t the greatest. This is when Omicron hit. But now we do actually have more. It would look like if you test positive for COVID, your doctor can order this or your pharmacist, and you would get treated as you would treat influenza with Tamiflu.

Dr. Laila Woc-Colburn:

The other exciting part is that besides that, for that pre-exposure, post-exposure prophylaxis. So for example, I’m a moderate to severe immunocompromised. So transplant patient, active chemo, low immune system, prednisone more than 20 mg, but I come into contact or [inaudible 00:16:27] says, “Someone around here had COVID,” but I don’t feel anything. I’m asymptomatic. I test negative. I can actually get a monoclonal called Evusheld that actually will prevent me from actually acquiring or developing moderate to severe COVID. We have those for our moderate to severe immunocompromised patients. That’s another exciting part that we can do. But that one requires you to go to a clinic because it’s either IV or subcutaneous.

Rick Bangs:

Yeah. That’s what I figured. That one probably was intravenous. All right. So let’s talk about boosters. Third shots are generally available. I think they’re plentiful in most locations, but the uptake on the third shots is surprisingly low. So what’s the status, and why is the status so low?

Dr. Laila Woc-Colburn:

So probably one reason that the booster is slow in the uptake it has to do a little bit with the vaccine hesitancy. Also, as the COVID numbers are coming down, people are like, “Oh, COVID is done. I don’t need this, so why get a shot?” But for our patients who are again, immunocompromised, so you’re actively getting chemotherapy, you have prednisone, your transplant patient, you actually do need that one because you don’t make memory cells or antibodies strong enough.

Rick Bangs:

Okay. So Dr. Lerner, you’re up. So we’ve got a lot of patients that are concerned about hospital and clinical transmission of COVID as they’re either being diagnosed or getting their bladder cancer treatments. So what’s the risk in those types of settings? Hospitals, and clinics? What are some of the things being done to mitigate those risks?

Dr. Seth Lerner:

So I think that today, the risk is pretty low for both hospital and outpatient clinic transmission of COVID. I think that you should certainly be aware of the so-called threat level, for lack of a better term, in your community. Laila referred to the three color-coded CDC categories. If you live in a community that’s green, that indicates very low transmission and quite frankly, I think, a very safe environment in the community. I think that gets translated to safety in the clinic and hospital. I think that patients and their caregivers should be assured that … I think this is the case in every hospital and clinic, at least in the US, that staff are required to be vaccinated. Now that requirement is being extended to booster shots and the penetration, so to speak, of that staff vaccination is likely to be in the very high 90s, so 98%, 99%. So from the people that you’re going to encounter at the staff level, we’d like to think that it’s a very safe environment. We continue to require that all patients and staff wear masks, so keeping each other safe.

Dr. Seth Lerner:

As far as testing goes, we’re beginning to relax the requirements for having a PCR COVID test. That’s generally been required within five days of a surgical procedure. There really are no outpatient procedures that we’re doing in the clinic for our bladder cancer patients that require testing. But for instance, if you are having an interventional radiology procedure, like having a drainage tube put in the kidney, those we’re also required to be testing. So I know where I work at Baylor St. Luke’s in the Medical Center in Houston effective today, the mandatory testing requirement was phased out for patients who are fully vaccinated by either Pfizer, Moderna, or J&J, so it doesn’t get you off the hook to be vaccinated. If you’re not vaccinated, then you need to be tested like you always have.

Dr. Seth Lerner:

I think Laila mentioned that all of us in the hospital are wearing surgical quality masks, KN95, N95, where it’s necessary. Then also in that environment, we’re still requiring social distancing. The medical staff, I think, largely abides by that, and we certainly ask the medical staff as well as the patients to assist with that. I think the hard part has been things like having loved ones accompany you into the hospital or stay with you. I think those requirements are also being liberalized. But again, I think it’s going to really depend upon the persistence of COVID in your community.

Rick Bangs:

Yeah. So still evolving and may have some regional variation is kind of the theme here. Okay. So another question for you, Dr. Lerner, should patients delay diagnostics or treatment in 2022 based on risk of potentially contracting COVID in the clinic or the hospital?

Dr. Seth Lerner:

Absolutely not. Never. We’ve been, and I think most clinics have been, treating patients and operating in this environment, quite frankly, within a few weeks after the pandemic really took off in full force in mid-March. There was a few weeks’ downtime, but we’ve worked very hard again, as I mentioned, to create a very safe environment.

Dr. Seth Lerner:

Unfortunately there’s a lot of data now, particularly in screening for cancer, lung cancer as an example, where there was a big lull and a big lag. What you saw was that patients, when they finally did get diagnosed, were being diagnosed with more advanced disease. We certainly don’t want to see that for any patient, and we certainly don’t want to see that in bladder cancer. So there’s no reason to delay. There’s no reason to delay treatment. Please, if you have any of the signs or symptoms that we have all of that information on the BCAN website, get checked out as quickly as possible. We’re here to take care of you.

Rick Bangs:

Okay. So should patients who have just been diagnosed get vaccinated if they haven’t been vaccinated already? Or should they get their third shot if they only got the first two shots?

Dr. Seth Lerner:

Absolutely. Yes and yes. Not only the patients, but their caregivers and family should get vaccinated and really be very meticulous about wearing masks, particularly out in public and social distancing to protect their loved one who may be going through a variety of different treatments which can impact the immune system. I think that Laila certainly can expand on this, but cancer patients in general, particularly if they’re immunocompromised either from their cancer or from their treatment, are at much higher risk for COVID and at much higher risk for having a bad outcome if they have COVID. As we’ve just been talking about, getting vaccinated is the best way and the safest way to protect you from a potentially bad outcome with COVID.

Rick Bangs:

Dr. Woc-Colburn do you want to comment?

Dr. Laila Woc-Colburn:

Yes. No, I completely agree with, with Dr. Lerner. I mean, we’ve proven this whole year, that vaccines is the biggest defense that we have right now. If you have not gotten vaccinated, I urge you to do it. Really, it’s actually what’s going to keep you from getting sick and protecting everybody that you love.

Rick Bangs:

Excellent. Okay. Dr. Lerner, let’s talk about the timing of getting these vaccinations versus the treatment. Let’s start with someone who’s just been diagnosed, but not vaccinated. When should they get their first vaccination relative to their bladder cancer treatment?

Dr. Seth Lerner:

Yeah, thanks. Ideally, they should get vaccinated before they start any treatment. But let’s break it down a little bit. So the vast majority of people who are diagnosed with bladder cancer have a form that we call non-muscle invasive cancer. That’s about 70% of patients when they’re first diagnosed. They have surgery to do a biopsy, remove the tumor, and then many of them will get what we call intravesical therapy, treatments instilled in the bladder. There’s really no issue about timing. They can get it at any time, really perhaps except the day of treatment. One of the drugs that we use, BCG, is a vaccine that can cause flu-like symptoms or irritative avoiding symptoms, and it would just be good to let those settle down, which they usually do within a day or two. If you’re having any fever or joint pain related to this kind of treatment, also let that resolve. The reason for that is that those symptoms may also pop up with vaccination, but they too also tend to resolve very quickly.

Dr. Seth Lerner:

Now, if you’re having an operation under anesthesia, whether it’s a bladder tumor resection or a radical cystectomy, it’s really a good idea to be vaccinated before that. I would say probably within ideally a week or two before the surgery, but probably I would avoid getting vaccinated within about 48 hours prior to surgery, again, because of these potential side effects of the vaccines. Then our preference would be to allow for full recovery after a transurethral resection of a bladder tumor, which is typically pretty quick. Cystectomy, I’d wait a little bit longer, maybe about three weeks, because during that time is when the highest risk for potential complications after the surgery, and you don’t want to confound a complication with potential side effects from the vaccine.

Dr. Seth Lerner:

Now, for a lot of our patients, they’re getting intravenous chemotherapy which can suppress the immune system, and again, better to be vaccinated prior to that. Then I think that’s really a conversation you need to have with the treating medical oncologist for chemotherapy specifically, and generally we’ve waited until after completion. Then of course, you have to be very meticulous with social distancing and masking.

Dr. Seth Lerner:

For the new immunotherapy agents, it doesn’t appear to be a problem getting vaccinated around the time of those drugs. Probably not the day of administration, but there does not appear to be a problem with immunotherapy agents. Then there’s some new targeted therapy agents, which really probably relates to the specific side effects of those, and you should have a conversation with your medical oncologist about that.

Rick Bangs:

Okay. So now let’s talk about the patient who has received two vaccinations. We are already talked about the fact that there’s still a number of people who haven’t gotten that third shot, the first booster. So let’s talk about them and what they should do about this third shot. So Dr. Woc-Colburn, do you want to take a swing at this because I think there’s some shifting sands here, and I want to make sure we’re getting the most current guidance.

Dr. Laila Woc-Colburn:

Yes. There has been some shifts on vaccinations, and it depends on your immune status. This new shift is something that recently came up through the CDC. So again, if you’re moderate to severe immunocompromised, so transplant patients, meaning either solid organ or bone marrow, if you are in actively chemotherapy, even if you’re using one of the check inhibitors, if you have prednisone more than 20, if you have some immunodeficiency syndrome like DiGeorge, where your immune system is going to be low, if you have untreated HIV or you’re an AIDS patient, those are what we call moderately to severe immunocompromised. They have come up with a new dosing schedule where you would get three doses plus a fourth dose. Everybody else gets three doses. That’s the new terminology. So a complete series would be three shots of the mRNA vaccine. If you do J&J, would be two doses, that’s the complete scheme and that’s what they’re calling a complete. So boosting is now being moved towards that either third shot for J&J or the fourth shot for mRNA.

Dr. Laila Woc-Colburn:

So going back to the question of where we stand is that we know that you’re not going to be fully vaccinated if you only have gotten two of them. That’s important because as you pointed out, Rick, not everybody wants to get vaccinated. So now with the new timing is that if you have not gotten vaccinated, your first vaccine will be, let’s say, April 1st, your second vaccine with an RNA would be three weeks later, so April 21st, and your third dose to complete the scheme would be four weeks later, so that would be May 21st. Your fourth dose, if you’re in the moderate to severe category, would be three months later, so that would be August.

Dr. Laila Woc-Colburn:

So that’s a little bit different on what the scheme that we have been giving for the last year. This has to do with the data that has come out. That might be confusing to our listeners in the podcast, but that doesn’t mean that the scheme given before was wrong. It’s just that we’re trying to make it a little bit easier on everybody.

Rick Bangs:

And we’re learning along the way. This is the latest information, so thanks for sharing that. So for patients who are planning to be treated for bladder cancer, they’re planning to be treated, should they get a fourth vaccine?

Dr. Laila Woc-Colburn:

It all depends. If you’re going to start getting chemotherapy, the recommendation would be yes. That would be three months opposed to the six months that we have been giving right now.

Rick Bangs:

Okay. Dr. Lerner, back to you. Do common bladder cancer treatments increase vulnerability to COVID and variants? I think you’ve already hinted at this, but just want to confirm.

Dr. Seth Lerner:

Yeah, so certainly cystectomy would, because during this sort of first few weeks after surgery, there’s a lot of things going on in the immune system and trying to heal the body so to speak. We’ve had patients unfortunately develop COVID, perhaps through contacts outside the hospital, when they go home during this time. But I think particularly as we just talked about systemic chemotherapy because it can definitely suppress the immune system, but not the checkpoint inhibitors.

Rick Bangs:

Okay. So now suppose I’m in treatment. Right now I’m in treatment or I literally just completed my treatment, and I live in an area where masking is not currently mandated, which I think is much of the country at this point. So given that most bladder cancer patients are over 65 and theoretically a little more vulnerable, what should they do about masking and social distancing?

Dr. Seth Lerner:

Well, again, as we’ve been talking, it depends. It depends a little bit on the stage of their cancer and the type of treatment that they’re getting. So I would say first and foremost, have that conversation with your treating urologist, medical oncologist or radiation oncologist. But I think I would be conservative and wear a mask and social distance, particularly in environments where I don’t know the vaccine status of the people around me. So that of course would be indoor areas, large gatherings, which we’ve been talking about and sort of all used to. Again, pay attention to what the color coding in your area is regarding the community status of COVID.

Rick Bangs:

Okay. Dr. Lerner, I heard that results of a clinical trial were reported at GU ASCO last month, and it had to do with patients who did not have a response from BCG and that there might be some interesting results relevant to today’s discussion. So what can you tell us?

Dr. Seth Lerner:

Yeah. So there’s a whole lot of activity and drug development in the disease state that we call BCG unresponsive non-muscle invasive bladder cancer. So it’s simply patients who’ve had at least an induction course weekly for six weeks and one three-month maintenance. Maybe they have a period of time where they appear to be cured and then recur or they never are a disease-free and still will have a high-grade cancer. So that’s the group and there’s a ton of drug development and clinical trials going on.

Dr. Seth Lerner:

But this was the particular drug, and I don’t have any relationship with the company, I was not part of the trial, but it’s called N-803. It’s a cytokine called IL-15 superagonist. But interestingly, it’s given with BCG in this group of patients for whom we don’t think BCG by itself would work anymore.

Dr. Seth Lerner:

Without getting into the details of why the two were given together, they’ve hit upon this concept of what’s called trained immunity that is associated with particularly BCG vaccination for tuberculosis. What it simply means is that in addition, say for BCG vaccination to protect from tuberculosis, it appears to also protect from other viral respiratory illnesses, yellow fever, for example. The science behind it seems to indicate that the vaccination does what’s called epigenetic modification of immune cells and training them to respond not just to tuberculosis, but to other … Although tuberculosis is bacterial, but to other viral and respiratory infections.

Dr. Seth Lerner:

This actually was the strategy that we used in a clinical trial of BCG vaccination for COVID. It turns out that in countries that have a national vaccination program, there was a tenfold lower risk of COVID and a tenfold lower risk of death related to COVID. That was reported in the peer-reviewed literature. There’s some interesting things about BCG that are not all related to bladder cancer. People have asked, “Well, if I’m vaccinated, is BCG going to work better?” We’re actually doing a clinical trial to ask that question, but unfortunately it doesn’t look like it protects you from bladder cancer, so you still need to get checked out.

Rick Bangs:

All right. All right. We may ask a follow-up question next year. All right. Dr. Woc-Colburn, I’m going to give you the last word. So if we do a sequel to this podcast in 2023, and it sounds like we probably would be, what do you predict will be new and what won’t?

Dr. Laila Woc-Colburn:

So in a year from now, unfortunately, predictions are always hard, but what we will have is we’re looking at COVID-19 to be something of a seasonal virus. So we’ll see that there is going to be a peak probably during the winter season, because we know that SARS or coronavirus are more predominant during the winter season. We’ll have probably some combination of vaccines or vaccines 2.0 that are a little bit better. Definitely there’ll be more potential oral antivirals out there in general.

Rick Bangs:

Okay. We’ll look forward to that. So I want to thank you both for your time today. You’ve given us a terrific understanding of the current state of COVID here in the US and how the bladder cancer community can navigate its many challenges. Dr. Woc-Colburn, in case people would like to get in touch with you, could you share your Twitter handle?

Dr. Laila Woc-Colburn:

Yes, I’m at Twitter @docwoc71.

Rick Bangs:

Okay. Thank you. Just a reminder, if you’d like more information about bladder cancer, you can contact the Bladder Cancer Advocacy Network at 1-888-901-2226. That’s all the time we have today. Thank you for listening, and we’ll be back soon with another interesting episode of Bladder Cancer Matters. Thanks again, Dr. Lerner and Dr. Woc-Colburn.

Dr. Seth Lerner:

Thank you.

Dr. Laila Woc-Colburn:

Thank you.

Voice over:

Thank you for listening to Bladder Cancer Matters, a podcast by the Bladder Cancer Advocacy Network or BCAN. BCAN works to increase public awareness about bladder cancer, advance bladder cancer research, and provide educational and support services for bladder cancer patients. For more information about this podcast and additional information about bladder cancer, please visit bcan.org.