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UROSCAN
Year : 2006  |  Volume : 22  |  Issue : 3  |  Page : 284
 

Palliation in urological malignancy


Department of Urology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India

Correspondence Address:
N Gupta
Department of Urology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Gupta N, Srivastava A. Palliation in urological malignancy. Indian J Urol 2006;22:284

How to cite this URL:
Gupta N, Srivastava A. Palliation in urological malignancy. Indian J Urol [serial online] 2006 [cited 2019 Nov 17];22:284. Available from: http://www.indianjurol.com/text.asp?2006/22/3/284/27651

Joon-Ha Ok, Frederick J. Meyers and Christopher P. Evans. Medical and surgical palliative care of patients with urological malignancies. J urol. Vol. 174, 1177-1182, October 2005.



   Summary Top


Urological malignancies are relatively common and patients often live many years with disease. There are many effective medical and surgical palliative treatments, although few comprehensive guidelines have been published. This article has reviewed the various palliative treatments available for the three most common urological malignancies, namely prostate cancer, bladder cancer and renal cancer. Authors have carried out a literature search of 15 years using MEDLINE/ Pub Med. In addition, relevant journals were targeted for specific information related to this review. Authors also combined their clinical experience with the current literature to create guidelines for palliative care.

The search revealed that several effective treatments are available for the palliative care of patients with prostate, bladder or renal cancer. Options in palliative care are varied with regard to invasiveness, morbidity, risks and benefits. The algorithms described provide a framework to a sequential approach to achieving palliation. Urologists are central to initiating care and referrals to improve outcomes in these patients. Authors concluded that the supportive care begins at initial diagnosis and should be flexible to meet the changing needs of patients with cancer.


   Comments Top


In this review the authors have provided a guide to palliative medical and surgical care options in patients with advanced prostate cancer, bladder cancer and renal cancer. Initial care of advance prostate cancer is androgen deprivation therapy but management of specific symptoms like bone pain, pelvic pain, bladder outlet obstruction, ureteral obstruction, spinal cord compression has been very clearly discussed with the use of flow charts. Similarly stepwise approach to the management of bleeding and pain in advanced bladder and renal cancer has been very satisfactorily outlined. The article also stresses the need to integrate palliative care throughout the illness even when cure is impossible and not to equate it with the end of life care.




 

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