Bladder cancer: time for a rethink?

In this issue of ONCOLOGY, Kamat and Mathew provide an excellent overview of the current status and future imperatives of bladder cancer treatment and research. As the authors highlight, and as other experts have recently written,[1] a paradigm shift is long overdue. The basic management of bladder tumors has remained essentially unchanged for over 50 years, and despite its importance—on account of the incidence, prognosis and cost of the disease—bladder cancer research remains significantly underfunded.[2] Every aspect of our perception and management of this disease requires change; abandoning the use of the term "superficial" bladder cancer is just the first step[3]—the term is both inaccurate and implies a lack of importance that is completely wrong. In particular, given the very high costs to healthcare systems from long-term surveillance and treatment of the disease,[4] it is particularly surprising that there has not been more emphasis on the disease from health policy makers and pharmaceutical companies.