Intravesical Bleomycin in Treatment of Carcinoma of the Bladder

To the Editor.— Bleomycin (Blenoxane), an antibiotic with antineoplastic properties, has been used extensively in the treatment of various malignant tumors in Japan and in the United States. Significant responses have been observed in patients with squamous cell carcinoma of various organs, lymphoma, and testicular tumors. No apparent response was reported in 14 cases with bladder carcinoma that have been treated with systemically administered bleomycin, 1 which is associated with important skin and pulmonary complications especially pulmonary fibrosis. The effectiveness of intravesical application in a patient with bladder carcinoma is presented. Report of a Case.— A 76-year-old man underwent transurethral resection of the prostate in early 1972. In October, an excretory urogram revealed minimal blunting of calyces but was otherwise normal. The urine cytologic study disclosed poorly differentiated malignant cells, and bone marrow aspiration showed moderate normoblastic hyperplasia, mild plasmocytosis, but no tumor cells. Cystopanendoscopy showed multiple papillary bladder tumors