Thanks for your question on HCM. I can understand your problem and situation from which you are going through. But honestly speaking there are not much options available for stage 4 bladder cancer pain. You can try transdermal patch of centrally acting pain killers. Its effect lasts for 72 hours. And has excellent effect. Another way is low dose sedative drugs. They sedate you mildly so that you can percieve less pain. In rare cases debulking surgeries are done to reduce pain but only after oncosurgeon s consultation.