Your first appointment at Fred Hutchinson Cancer Center is a time for you and your care team to meet. You will talk about your diagnosis, disease outlook and likely treatment. This visit is also a time for us to start getting to know you as a person. This helps us fit our recommendations to you. Together, you and your care team will decide what needs to happen next.
We encourage you to bring a family member or friend to your first appointment (and any future visits).
When you come to Fred Hutch, we match you with the health care services and providers that are right for you. Your care here is always personalized. We tailor your first appointment — and all your visits with us — to your unique situation.
The plan for your first appointment will depend on if your cancer:
We will also think about any treatment you have already had.
If you have a related cancer of the upper urinary tract, such as the ureter, renal pelvis or urethra, your first appointment will be similar to a visit for bladder cancer.
If you have non-muscle invasive bladder cancer and you have not had treatment yet, our urologic oncologists are the experts who will plan and provide your care. Your first visit will be with this type of doctor. Most people in your situation have cystoscopy (a procedure to look inside the bladder and remove the tumor). This is often followed by chemotherapy that the surgeon puts directly into the bladder during the cystoscopy procedure. Your urologic oncologist will then decide if you need more treatments (BCG therapy or chemotherapy) directly in the bladder.
If you have non-muscle invasive bladder cancer that did not respond to BCG therapy or came back after BCG therapy, you may need different types of treatment. These can include surgery, medicine-based options or radiation therapy. Our Bladder Cancer Multispecialty Clinic is designed for you. There, you will see several specialists in a single day. Together, they will recommend a complete, personalized treatment plan for you.
If cancer has gone into the muscle wall of your bladder but has not spread to distant parts of your body, you may need two or more types of treatment. These can include surgery, medicine-based options or radiation therapy. Our Bladder Cancer Multispecialty Clinic is designed for you. There, you will see several specialists in a single day. Together, they will recommend a complete, personalized treatment plan for you.
If you have metastatic bladder cancer, our medical oncologists are the right match for your needs. They specialize in medicine-based treatments for bladder cancer and other cancers of the urinary tract. You will likely start by seeing one of them first. Most people in your situation need chemotherapy. They usually do not have surgery. They may have immunotherapy, targeted therapy or other treatment. Sometimes, they need radiation therapy to help with cancer-related symptoms.
Many people with bladder or other urinary tract cancer need more than one type of treatment. This means they need more than one type of physician. We bring a team of genitourinary specialists together for you in one place: the Bladder Cancer Multispecialty Clinic (BCMC). This clinic is at UW Medical Center – Montlake. It is our one-stop shop, where we guide you through complex treatment decisions. At the BCMC, we provide seamless, comprehensive, patient-centered care.
The BCMC is for people whose cancer has gone into the bladder muscle layer but has not spread to distant parts of the body. It is also for people who started treatment for non-muscle invasive bladder cancer and whose cancer did not respond to BCG therapy or came back after BCG therapy.
The BCMC gives you a “home” where you can see a urologic oncologist, medical oncologist and radiation oncologist all on the same day. The clinic is held once a week in the Genitourinary Oncology Center in the Urology Clinic, which is located in the Surgery Pavilion at UW Medical Center – Montlake.
Our physicians are from UW Medicine, and they specialize in bladder cancer and other cancers of the urinary tract. They will work with you as a team to plan and provide the care you need.
Our BCMC is the first clinic in the region to provide this type of multidisciplinary care for people with bladder cancer. We treat all types of the disease, from urothelial cancer, the most common type, to rare types and variants.
As a new patient, you will get a complete evaluation of your unique case. You will leave your appointment with a personalized treatment plan and a clear set of next steps.
The first visit usually takes about four hours (8 a.m. to 12 p.m.). You will spend about three hours with your physicians. Here is what you can expect to happen.
Hour 1 – Exam
You will meet with a resident doctor or fellow, who will talk with you about your health history and do a detailed physical exam.
Hour 2 – Team Meeting
Your team of physicians will meet to talk with each other about your cancer and the most effective and safe ways to treat it. During this time, you can visit the Patient Resource Center and other UW Medical Center amenities.
Together, the team will design a treatment plan specifically for you.
Hours 3 and 4 – Recommendations
You will meet one-on-one with each physician from your team. You will stay in the same room, and the physicians will come to you. We will explain the treatment we recommend for you and why. We are here to answer your questions and talk through your options so you can make well-informed and shared decisions you feel good about.
What Happens Next?
Before you leave, you will meet the BCMC program coordinator. We will help schedule any appointments you need next. Your schedule will depend on your exact needs. We are here to handle the details and make the process as worry-free as possible for you.
Having a team of experts in one room at the same time is linked to:1
At the BCMC, we often take another look at the test results and imaging that patients have had elsewhere. This allows us to update your diagnosis and disease stage in important ways that affect your treatment choices.
1. Leonidas N. Diamantopoulos et al, “Bladder Cancer Multispecialty Clinic (BCMC) Model Influences Disease Assessment and Impacts Treatment Recommendations,” Bladder Cancer 5 (2019): 289–298
For many of our patients, the first step is to see a single physician who specializes in the main type of treatment they are likely to need.
If you have non-muscle invasive bladder cancer with no prior treatment, you will see a urologic oncologist at UW Medical Center – Montlake who can talk with you about surgery and other treatment options.
If you have metastatic disease, you will see a medical oncologist who knows the very latest about treating bladder and other urinary tract cancers with systemic therapies. Your medical oncology appointment may be either at UW Medical Center – Montlake or at the Fred Hutch South Lake Union Clinic. We will make sure you know where to go.
First appointments with these physicians usually last about one hour. Here is what you can expect to happen.
Here are tips about how to prepare for your first appointment at Fred Hutch and what to bring.
Just like every patient’s situation is different, every caregiver may be asked to help with different tasks. Learn how you can offer support during a first visit.
Just like every patient’s situation is different, every caregiver may be asked to help with different tasks.
As a caregiver, you can give your loved one both emotional and practical support for their first appointment. Ask them if you can help with things like these: