Hi … thank you so much for your caring comment. Yes, due to the painful bladder issues, I was put under the care of a palliative MD in addition to everything else. She has me on a pain mgt protocol which is helpful. Of course, this includes opioids - Norco and time release morphine. Both cause constipation but the palliative MD has me on daily laxatives and this has resolved the constipation. Also, my oncologist and pcp have me seeing a very good urologist who has me on bladder medication. I take it infrequently, however, because it dries my mouth and ruins my appetite - to the point of not eating. I have a stent in my right urether (sp) to open it up as cancer has clogged it. The urologist replaces it every few months as it tends to mineralize and this is one source of pain. So yes I am doing everything I can to work with the bladder side effects of TIVDAK but it is a struggle to get on top of the problems. I am having a scan in a few days to see if TIVDAK is even working, and I shall go from there. Thank you again.