Palliative treatment of carcinoma of the urinary bladder

It would seem from the analysis of this series and the experience of others4, 5, 6 that there is no advantage in treating patients with bladder carcinoma in the advanced stage. Symptoms due to intractable bladder spasm, continuing vesical hemorrhage or hydronephrosis may be abated temporarily by urinary diversion, but the ultimate survival is not influenced by such procedures and may be shortened because of the possible complications of the operative procedures. It is our feeling that a patient with an advanced stage of bladder carcinoma probably will benefit most when the physician withholds aggressive palliative treatment and merely supports the patient with needed analgesics or narcotics until death ensues. However, it is our impression that an occasional patient has benefited from palliative radiation. Therefore, it should be employed where intractable bleeding and bladder spasms are present.