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August 21, 2017. We can start by agreeing that things can get contentious when it comes to the management of genitourinary cancers. Muscle-invasive bladder cancer (MIBC) is one such disease over which a well-known argument has raged for years: is radiation and chemotherapy to preserve the bladder really as good as surgical removal? As discussed last month, we haven’t made much progress in directly comparing these treatments head to head. But luckily the AUA, ASTRO, and ASCO have all teamed up this summer to produce a consensus clinical practice guideline. This is one small step for the clinical management of MIBC, and one giant leap for interdisciplinary arbitration. So while we’re still lacking high quality clinical trial data, we see this first of its kind consensus paper as the bladder half full.