Therapy for Genitourinary Cancer

The ultimate objective of therapy for genitourinary malignancies is cure without any adverse effect on quality of life. Therapy for Genitourinary Cancer addresses modifications of standard surgical procedures that purport to decrease the morbidity of therapy for testis cancer and renal cell carcinoma without compromising cure. The rationale for decreasing the extent of surgical extirpation for bladder cancer and rhabdomyosarcoma is also summarized. The ability to limit the extent of therapy depends upon the ability to predict the metastatic potential of the primary tumor. The application of cell motility and of DNA ploidy to predict the metastatic potential of prostate cancer are presented. Since little progress has been made to enhance survival rates for prostate cancer, more aggressive treatment regimens are presently being advocated. In this volume, the roles of adjuvant radiotherapy following radical prostatectomy, and complete androgen suppression for metastatic prostate cancer are reviewed as well as the preliminary experiences with suramin, and the implications of combining tumor necrosis factor and chemotherapeutic drugs. The use of bladder substitution with intestinal segments has enhanced the quality of life following pelvic exerterative surgery; the development of carcinoma in these intestinal bladders is discussed. Therapy for Genitourinary Cancer reflects the commitment of clinicians and basic scientists to enhance the effectiveness of therapy for genitourinary malignancies. It is hoped that the innovative approaches to treatment presented in this volume will gain clinical acceptance and improve our ability to cure these tumors.