Purpose: To characterize the effect of palliative care provided concurrently with usual urologic care for patients with bladder cancer
undergoing cystectomy.
Materials and methods: Prospective, 6-month, serial cohort study comparing 33 participants receiving usual care with cystectomy for
muscle-invasive bladder cancer, with 30 participants also receiving concurrent palliative care. Patients and family caregivers completed
validated symptom assessment and satisfaction surveys preoperatively and at 2, 4, and 6 months postoperatively.
Results: The intervention group saw improvements in most symptom measures over the 6 months following cystectomy compared with the
control group. Depression and anxiety decreased over the 6-month period for the intervention group patients but increased over this time among
the controls (P ¼ 0.01). Fatigue decreased to a minimum for the intervention group participants at 4 months, whereas it peaked at this time for
control participants (0.002). Quality-of-life and posttraumatic growth scores followed a similar pattern, with scores peaking at 4 months for the
intervention group whereas controls reported their lowest scores at this time (P ¼ 0.01 and P ¼ 0.03, respectively). Changes in pain scores did
not reach statistical significance. Neither family caregiver burden nor patient satisfaction showed statistically significant changes over time.
Conclusions: Patients who received concurrent palliative care in addition to usual urologic care following radical cystectomy for muscle-
invasive bladder cancer had better outcomes, including improved fatigue, depression, quality of life, and posttraumatic growth. Although
further research on this topic is needed, our results suggest that providing palliative care services in addition to usual urologic care for
patients with bladder cancer may significantly reduce postoperative symptoms.