Bladder cancer is a disease that often requires oncologists to work alongside urologists to achieve the best outcomes. The standard treatment for bladder cancer or urothelial cancer for many years was radical surgery by itself. Recent data have shown that chemotherapy works well to help shrink the tumor and increase the chance of cure with either surgery or radiation. For advanced bladder or upper urothelial cancer, the standard of care is often upfront chemotherapy prior to surgery (called neoadjuvant therapy). Unfortunately, only about 20% of patients nationally are offered chemotherapy. It is important that your urologist work closely with oncology to make sure we are not missing an opportunity to improve chance of cure upfront.