I. The Treatment of Cancer of the Bladder by Radium

Abstract

Cancer of the bladder can be attacked by a variety of methods. The growth can be destroyed by diathermy, by radiation, or by a combination of these two measures. A segmental resection of the tumour-bearing area can be carried out, or the entire bladder can be removed after the urine has first been deviated by implantation of the ureters into the bowel. Those who would essay the treatment of bladder cancer should be prepared to employ any of these measures, for no one of them can be applicable to all cases. High voltage X-ray therapy applied either by inserting a narrow cone into the bladder through a cystostomy opening, or by external radiation, also claims a place in the treatment of cancer of the bladder. I have had no experience of this method, and am, therefore, unable to offer any personal opinion as to its value. Reports from other workers in this field give the impression that X-ray therapy in bladder tumours has a limited sphere of usefulness, and by itself will seldom achieve absolute cure, though it may bring about regression of a tumour. Diathermy is accepted as the method of choice in the treatment of the pedunculated villous papilloma, a tumour generally regarded as benign in character. Such a papilloma can be completely destroyed by the perurethral route, though if large in size more than one treatment may be required, and sometimes the bulk of the growth will necessitate an approach through the supra-public route.