Cancer of the bladder is most commonly transitional cell carcinoma derived from the lining epithelium (around 90%), with the rest composed of squamous cell carcinomas and adenocarcinomas. 70% of patients with bladder cancer are diagnosed with non-muscle invasive tumors that are successfully treated with local endoscopic resection. While these tumors are not often life threatening, their management requires intense follow-up to monitor for recurrence.

There is a need for molecular and cellular characterization of non-muscle invasive tumors that are likely to progress so that appropriate follow-up can be instituted and effective tools for detection of recurrence can be developed. For patients with muscle invasive bladder cancer we must also develop tools that will permit the classification of the risk of metastasis, and the development and use of personalized therapeutic selection strategies based on host and tumor characteristics. Such characterization would provide significant advances in bladder cancer therapy by targeting the use of novel and established agents only for patients who would benefit, while sparing others unnecessary toxicity.

There are many treatment options for bladder cancer, including behavioural, chemical, surgical and radiological approaches, but there are few data about them to provide informed good choices. It would be helpful to be able to use risk classification tools effectively in either the neo adjuvant and/or adjuvant setting to select which patients should receive such treatments. Development of new agents and novel treatments, and determining optimal therapy for both of the disease phenotypes is a top priority. The need for effective new agents is especially acute for patients with metastatic disease who have a nearly universal fatal outcome with current regimens.

Research in bladder cancer should be linked to efforts in prostate and renal cancer. Since urinary tract infection and inflammation seem to be capable of inducing neoplastic changes, connections should be made to these areas as well. Quality of life issues must be addressed for bladder cancer survivors. They are often significant, especially in patients with muscle invasive disease and urinary diversion.

Journal of Nephrology and Urology is an Open Access peer-reviewed publication that discusses current research and advancements in diagnosis and management of kidney disorders as well as related epidemiology, pathophysiology and molecular genetics.

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