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Management of genitourinary malignancies, including cancers of the prostate, bladder, kidney, and testis, involves a multidisciplinary approach integrating surgery, radiation therapy, systemic treatments, and targeted therapies. Prostate cancer treatment ranges from active surveillance for low-risk cases to radical prostatectomy, radiation therapy, and androgen deprivation therapy for advanced disease. Bladder cancer management includes transurethral resection for non-muscle-invasive disease and radical cystectomy with or without chemotherapy for muscle-invasive cases. Kidney cancer treatment primarily involves surgical options such as partial or radical nephrectomy, supplemented by targeted therapies like tyrosine kinase inhibitors and immunotherapy for metastatic disease. Testicular cancer, highly curable even in advanced stages, is managed with orchiectomy followed by chemotherapy or radiation, depending on the type and stage. Emerging treatments, including immunotherapy and personalized medicine, are increasingly important, particularly in advanced or refractory cases. Each patient's treatment plan is individualized, based on cancer type, stage, genetic markers, and overall health, ensuring the most effective and comprehensive care. Regular follow-up and monitoring are crucial for early detection of recurrences and management of treatment-related side effects.