Cancers of the Urinary System

Abstract

Cancers of the urinary system – such as the kidneys, urethra, and bladder – have traditionally been diagnosed and managed by urologists. The role of radiation therapy has been limited historically as non-operable patients were considered incurable. However, trimodality organ preservation has been established as an acceptable alternative to radical cystectomy for patients with muscle-invasive bladder cancer, and organ preservation continues to evolve in other GU malignancies – penile, urethral, and renal cancers. The integration of organ-preservation approaches is not easy due to existing onco-politics and requires expertise and knowledge of contemporary clinical research, most of which takes place outside of the United States. This section aims to reinforce the indications of radiation therapy and the rationale of these indications backed by clinical research findings. This section has been updated to include eighth edition AJCC staging classification and contemporary understanding of appropriate patient selection for organ preservation management.