1978 Gordon Richards memorial lecture. Assessment and management of bladder cancer.

The importance of radiology in the assessment of patients with bladder cancer is discussed. Particular mention is made of the contribution of excretory urography, lymphography and sonography. The result of treating 222 patients with transitional cell cancer of the bladder by megavoltage irradiation is reported. A case is made for a re-evaluation of primary radiotherapy, particularly for deeply invasive (T3a) and extra-vesical cancers (T3b) without fixation or spread to other organs. Radiotherapy alone may produce results as good as surgery for well-differentiated grades of tumor. Patients with locally advanced, poorly-differentiated (Grade III) cancers require systemic chemotherapy in addition to local radiotherapy, because of the high probability of latent disseminated disease.