Bladder cancer

One of the most significant developments in the diagnosis and screening of bladder cancer is to use molecular genetic techniques and various diagnostic tools in hopes to adjunct cystoscopy, which is still the gold standard in diagnosis, and to define patients who are to be assigned more aggressive therapy. Although these techniques cannot replace cystoscopy, the promising results from these studies indicate that at least the frequency of control cystoscopies in the follow-up of low-risk patients may be decreased by the help of these tools. Bladder reconstruction following nerve-sparing cystectomy may represent the best primary surgical approach for organ-confined invasive disease at the present time. It is not yet clear whether bladder preservation with chemoradiation protocols will yield similar long-term disease free rates as in surgical series. However, it may be overoptimistic to think that appropiate randomized trials will address this question in the near future because physicians seem to have strong prejudices for one approach or the other.