How would you manage an elderly, medically inoperable patient with high-grade, muscle-invasive bladder cancer who has already received definitive prostate irradiation?  

The more patients with prostate cancer we treat and the longer they live, the more likely this is to happen. While cystectomy is the right thing to recommend, it is often a very difficult operation as continent diversions are impossible, and the risk of bowel injury is high. If the patient is elderl...

I had a recent patient like this and I've found out that using IGRT helps. We've used intravesical markers or MR-IGRT to better focus the boost for the recurrence and new cases as well.