The role of urologist

Abstract

The urologist will have a key-role in the prevention and management of bladder cancer (BC), also in the future. This chapter focuses on the possible changes in whom the urologist will be involved. First subchapter discusses the nature of BC as a preventable disease. Cigarette smoking is the most preventable cause of BC and more efforts should be done to encourage smoking cessation among general population and newly diagnosed BC patients. Second subchapter focuses on early detection of BC. In future, improved definition of high risk populations suited for screening together with the development of integrated multi-markers models may improve early detection of urothelial cancer. The third subchapter is dedicated to intravesical therapies and how can be done best in the management of BC. BCG is still the best adjuvant treatment for intermediate and high-risk NMIBC, for patients who experience BCG failure, to date; only Valrubicin is FDA approved therapy. Forth subchapter is focused on precision medicine and immunotherapy for BC patients. PD-1/PD-L1 checkpoints blockades are approved therapies in second line metastatic BC and in first line cisplatin-ineligible BC because of their high efficacy and tolerability. Knowledge of the side effects and experience in their management is essential to optimal patient care.