Abstract
Palliation in advanced cancer (Introductory Figure) is mainly relief from distressing symptoms. Subjective improvement by any modality is not considered effective unless it is accompanied by some objective regression of the tumor. Treatment for stage D bladder cancer can give the patient benefit without always directly attacking the cancer. Major complaints are related to obstruction, infection, and hemorrhage, and each can be relieved by different maneuvers requiring either surgical treatment or radiotherapy. Diversion of the urinary stream is an important contribution to caring for this stage of bladder cancer; numerous means of accomplishing this task are available. The morbidity and mortality must be considered and depend upon the medical problems of the host. Often, diversion may be sufficient to provide symptomatic relief, but hemorrhage and infection may not be controlled without vigorous treatment. Jacobs presents his views on this topic. Irradiation for advanced cancer with intent to palliate may require
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