The Role of Medical Oncologist

Abstract

The current position of the medical oncologist is clear in those patients who have metastatic disease at the time of diagnosis, or who develop metastatic disease following radical treatment. However, the role of the medical oncologist in the management of bladder cancer is rapidly changing. The advent of immune checkpoint inhibitors (those targeting PD(L)-1 and CTLA4) is already beginning to change the way advanced bladder cancer is treated. It is likely that these new interventions will not only improve outcomes where used in combination (either simultaneously or sequentially) with chemotherapy, but also broaden access to systemic therapy to a wider group of patients. It is, therefore, likely that the oncologist will become a more active member of the multi-disciplinary team for a wider group of patients with bladder cancer across a broader spectrum of the disease. Moreover, since we move into the age of molecular stratification and precision medicine, a streamlined engagement between surgeons, medical oncologists, molecular pathologists and radiation oncologists has the potential to improve outcomes and better meet the needs of patient with bladder cancer.