Bridging urology and palliative care - A narrative review of current practice and evolving priorities

Sep 22, 2026

Uploaded by Grenda

This narrative review synthesizes evidence from 2023–2025 on palliative care’s role in urology, emphasizing advanced genitourinary malignancies. It addresses palliative care utilization trends and persistent access disparities across diseases and care settings, including differences by ethnicity and insurance status. The review highlights substantial symptom burden, inconsistent integration into routine urological practice, and communication gaps about prognosis and end-of-life preferences. It also outlines procedural palliative needs where urologists directly influence symptom-directed care.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Purpose of review

Recent findings

Summary

Introduction

Key points

REVIEW UPRI RNIENTON Bridging urology and palliative care: a narrative review of current practice and evolving priorities Andreas Bannera,b, Stephan Madersbachera,c, Lee A. Hugardand Eva K. Masele Purpose of review This narrative review summarizes recent evidence (2023–2025) on the role of palliative care in urology. It focuses on utilization trends, access disparities, symptom burden, procedural palliative needs, and end-of-life (EOL) care in advanced genitourinary malignancies. Recent findings PC utilization in genitourinary cancers is increasing. Inpatient palliative care use rose from 4 .9 to 31 .5% in renal cell carcinoma and from 5 .9 to 19 .0% in testicular cancer. Yet, integration into routine care remains inconsistent. Disparities persist, including lower palliative care utilization among certain ethnic groups and uninsured patients, and higher odds of receiving high-intensity EOL care among socioeconomically vulnerable populations. Symptom burden remains substantial, with up to 82% of patients reporting multiple symptoms. This underscores the need for more timely palliative care involvement and more standardized reporting. Communication gaps, particularly regarding prognosis and EOL preferences, highlight opportunities for urologists to engage more actively in initiating palliative care discussions. Procedural palliative needs, including malignant ureteral obstruction management, illustrate the direct impact of urologists in providing symptom-directed palliative care. Summary Despite growing recognition of palliative care gaps remain in access, referral timing, and systematic assessment. Addressing disparities, enhancing interdisciplinary collaboration, and prioritizing prospective research will be essential to improve patient and caregiver-centered outcomes. Keywords end of life, genitourinary cancer, narrative review, palliative care, urology INTRODUCTION Palliative care is now recognized as crucial for the management of urologic conditions - especially advanced genitourinary cancers given increasingly complex clinical, psychosocial and public health challenges that extend curative treatment [1,2] . Palliative care is specialized medical care for people living with chronic or serious illnesses, aimed at alleviating the symptoms and stress of the illness for both the patient and their caregivers [3] . Use of palliative care principles provides an extra layer of support, and is appropriate for patients of any age and at any stage of a serious illness. Hospice care represents a specific form of palliative care reserved for patients with limited life expectancy. Although no universal consensus definition of hospice exists, it generally differs from broader palliative care in that life-prolonging treatments are typically discontinued at the time of enrollment [2] . By contrast, palliative intent refers to the goal of a specific treatment or intervention aimed at prolonging survival while maintaining or improving quality of life, rather than achieving cure [4] . In this context, it is important to note that many palliative care studies rely on large aDepartment of Urology, Klinik Favoriten, Vienna, bDepartment of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, cSigmund Freud Private University, Vienna, Austria, dDepartment of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, USA and eDivision of Palliative Medicine, Department of Medicine I, Medical University of Vienna, Vienna, Austria Correspondence to Andreas Banner, MD, Resident Physician, Klinik Favoriten-Department of Urology, Kundratstrasse 3, A-1100 Vienna, Austria Tel:+43 60191 4807; e-mail: [n1346190@students.meduniwien.ac.at](n1346190@students.meduniwien.ac.at); [andreas.banner@gesundheitsverbund.at](andreas.banner@gesundheitsverbund.at)[ ](andreas.banner@gesundheitsverbund.at)[Curr Opin Urol](Curr Opin Urol 2026)[ 2026](Curr Opin Urol 2026), [36:423](36:423)–[430](430) [DOI

FAQs

What does this narrative review focus on in urology?

It summarizes recent evidence on the role of palliative care in urology, especially for advanced genitourinary malignancies and associated end-of-life care.

How is palliative care utilization changing in genitourinary cancers?

Utilization is increasing, including rising inpatient palliative care use in renal cell carcinoma and testicular cancer, but integration into routine care remains inconsistent.

What barriers and clinical needs does the review identify?

It highlights access disparities, substantial symptom burden, gaps in prognosis and end-of-life communication, and procedural palliative needs that directly reflect urologists’ involvement in symptom-directed care.

Sep 22, 2026

Uploaded by Grenda