Bladder carcinoma: Where are the patient advocates?

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Although bladder carcinoma is the fourth most common malignancy diagnosed in men and the eighth most common in women, little public information currently is available regarding this neoplasm. It appears that few clinicians are aware that because of the lifelong need to monitor for recurrence using cystoscopy, as well as the treatment of recurrent tumors, the cost per bladder carcinoma patient from the time of diagnosis to death is the highest among all malignancies in the U.S. In their study, Prout et al. suggest that patients with muscle‐invasive bladder carcinoma, in particular those in the older age groups, may not be receiving optimal treatment. Factors that may be responsible for this are discussed.See also pages 1563–6 and 1638–47.