A thorough understanding of epidemiology, risk factors, early detection strategies, diagnosis, and evaluation is essential for correct, evidence-based management of BC patients. Recent developments in endoscopic techniques and imaging raise the hope for providing better risk-adopted approaches and thereby improving clinical outcomes.

As the field continues to evolve, collaboration across the APAC region will be important to facilitate relevant research and collection and appraisal of data relevant to APAC populations. In the meantime, the APAC APCCC 2018 meeting highlighted the critical importance of a multidisciplinary team-based approach to treatment planning and care, delivery of best-practice care by clinicians with appropriate expertise, and the importance of patient information and support for informed patient choice.

Urological cancers during pregnancy pose many challenges for clinicians. As these tumors are very rare among pregnant women and their symptoms might mimic those of common pregnancy-related disorders, the diagnosis is often delayed. Once a urological tumor is diagnosed in a pregnant patient, appropriate steps should be taken to treat her and the fetus at the same time. A delay in treatment can risk the mother's life whereas an early treatment can risk the life of the fetus. Common urological cancers that might occur during pregnancy include renal cancer, bladder cancer and adrenal tumors, particularly pheochromocytoma. Ultrasonography and MRI, which use no ionizing radiation, are considered to be safe during pregnancy. Surgical intervention is safest if performed during the second trimester. The treatment outcomes of these cancers in pregnant women are no different from those in the general population. Early suspicion and timely intervention are crucial for successful treatment.

Introduction:A total of 356,557 new cases were diagnosed annually worldwide in 2009, it was estimated that 52,810 new patients were to be diagnosed with bladder cancer and there were 10,180 projected deaths from the disease in the USA. Despite being the fourth commonest cancer in men, we do not have an early detection/screening program for bladder cancer. The review was aimed at looking at the evidence for the rationale for an early detection program for bladder cancer.Materials and Methods:A detailed search on bladder cancer epidemiology, diagnosis, pathology, tumor markers, treatment outcomes, screening, morbidity and mortality of bladder cancer was carried out on Pubmed central/Medline. Original articles, review articles, monograms, book chapters on bladder cancer, text books on urological oncology, oncology and urology were reviewed. The latest information for new articles before publication was last accessed in June 2010.Discussion and Conclusions:Bladder cancer is the fourth commonest cancer in men, the annual death rate from this disease is significant and every year there is an increase in its incidence globally. The prognosis of bladder cancer is stage and grade dependent; the lower the stage (T2 or less) the better is the survival. Delay in the diagnosis and treatment does alter the overall outcome. Therefore, there is a clear need for early detection of bladder cancer and screening program. Although we do not have an ideal marker for bladder cancer, it is time we maximize the potential of markers such as UroVysion, NMP22 along with cytology to start such a program. May be as a first step the early detection and screening program could be started in high-risk population. It is not worth waiting till we find the best marker as it would be unfair to our patients. The fear of unnecessary tests and treatment in bladder cancer after its detection in screening program is without any substance. The cost-effectiveness of such a program is certainly comparable to that is used for colon or breast and for prostate as well.

Renal biopsy was performed in 17 patients using the balloon technique of endoscopy of the retroperitoneum. There was good exposure of the kidney and a sufficient amount of renal tissue was obtained in all patients with minimum postoperative morbidity. The preliminary results show that this method could become a safe and reliable alternative to open surgical biopsy.

Purpose: To evaluate Indian literature, clinical practice and develop consensus opinion on various aspects of prostate cancer diagnosis and management in order to assist medical practitioners across India in effectively choosing right treatment option for patients with prostate cancer. Materials and Methods: At the CAP summit held in Kolkata on 2019, a group of leading experts from across India voted on 42 consensus statements. Final statements were derived on the basis of voting results and subsequent expert panel meeting. Based on the panellists discussion on various areas of prostate cancer and practicability of recommendation in clinical practice, 5 statements were deleted and a draft was prepared. The draft is divided into 2 parts; part 1 covers 16 statements on prostate cancer diagnosis and early prostate cancer. Results: A total of 37 statements were accepted and finalised by expert panel members based on the voting results. Sixteen statements with varying degrees of support from the panel are described in detail in this article. Conclusions: The statements derived from several Indian scientific evidences, local clinical experience, and international guidelines will serve as a reference guide for clinicians across India in the management of prostate cancer.

Background:There is a significant variation in the treatment strategies adopted for the treatment of locally advanced T3b, T4a, N1-3 and metastatic bladder cancer. There is increasing evidence that we would be able to offer them some benefit in terms of disease-free survival and improving the quality of life. This article is aimed at reviewing the current literature on the treatment strategies in locally advanced and metastatic bladder cancer.Materials and Methods:Extensive literature search was done on Medline/Pubmed from 1980-2007 using the key words - treatment of locally advanced, metastatic bladder cancer. Standard textbooks on urology, urologic oncology and monograms were reviewed. Guidelines such as National Comprehensive Cancer Network guidelines, European Urology Association guidelines and American Urology Association guidelines were also studied.Results and Conclusions:There is a place for radical cystectomy in locally advanced T3b-T4 and N1-3 bladder cancer. Radical cystectomy alone rarely cures this subgroup of patients. There is increasing evidence that meticulous surgical clearance and extended lymphadenectomy has significant impact on disease-free survival. Adjuvant chemotherapy has been found to be effective in terms of recurrence-free survival and better than cystectomy alone. Neoadjuvant chemotherapy followed by radical cystectomy also has beneficial effects in terms of downstaging the disease and improving recurrence-free survival. This perioperative chemotherapy (adjuvant/neoadjuvant) has 5-7% survival benefit and 10% reduction in the death due to cancer disease. Excellent five-year survival rates have been achieved in patients achieving pT0 stage at surgery following chemotherapy (around 80%) and overall 40% five-year survival in node positive patients, which is promising. Though practiced widely, perioperative chemotherapy is not considered as a standard of care as yet. Current ongoing trials are likely to help us in reaching a consensus over this. There is no role of preoperative or postoperative radiotherapy in locally advanced/metastatic bladder cancer except in non TCC bilharzial/squamous cell carcinoma of bladder. Use of nomograms and prognostic factor evaluation may help us in the future in predicting the disease relapse and may help us in tailoring the treatment accordingly. Newer and more effective chemotherapeutic drugs and ongoing trials will have a significant impact on the treatment strategies and outcome of these patients in the future.

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