Nursing

Intensive care medicine

Prostate cancer

Percutaneous

Surgery

Malignancy

Medical physics

Percutaneous nephrostomy

Urinary diversion

Palliative care

Quality of life (healthcare)

Internal medicine

Oncology

Medicine

Genitourinary system

Bladder cancer

Disease

Cancer

Cystectomy

Public Health and Emergency

Urological malignancies are traditionally affecting people of older age, may not be upfront lethal, especially prostate cancer (PCa), and as a result urological patients often live many years with their disease. Recent advancement in the treatment of castration-resistant PCa have resulted in a prolongation of survival and an improvement in the quality of life even for of patients with advanced disease. The availability of new treatments that prolong life for cancer patients might result in an increase in the need for palliative care procedures as patients live longer and may suffer the side effects of treatment as well as the sequella of their underlying malignancy. This rather extensive review article will review the various palliative treatments available for the most common consequences and complications of genitourinary cancers. One of the most frequent everyday issues that will be discussed is the optimal management of upper urinary tract obstruction caused by malignancy. There has been considerable debate over whether stent placement or percutaneous nephrostomy (PCN) provides better patient care in terms of drainage, preservation of renal function and quality of life. Preservation of bone health and management of skeletal related events will be discussed along with the management of lower urinary tract obstruction by either indwelling or intermittent catheterization for patients with bladder outlet obstruction (BOO) will. The available options and the benefits and drawbacks of catheters versus urethral stents will be discussed in detail. The problems of recurrent intractable hematuria and paraneoplastic syndromes (PNSs) will be addressed as they greatly affect quality of life by requiring repeat hospital admissions.

Palliative care issues in advanced urological malignancies