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Urologic cancer in Japan: role of Japan at the frontier of issues in Asia. The characteristics of urological cancer in Japan can be summarized in the following points. (i) As the onset of this type of cancer is typically seen in elderly patients, it is becoming a major social issue in Japan that has already become an aging society. (ii) Many diverse treatment methods are available and a response is required that prioritizes quality of life. (iii) Although vigorous research and development efforts into new drugs are being carried out on a global level, resulting in beneficial medical agents becoming more readily available, unless concepts relating to cost vs. effectiveness are further developed and there is a real risk that medical systems and structures in their current form will become unsustainable. (iv) Although at the current point there are no original large-scale clinical trials being conducted in Asia, Japan has a wealth of experience of participating in many international joint clinical trials and it is therefore an urgent and pressing challenge to organize joint clinical trials in Asia and amass a body of knowledge that is unique to Asia. In view of this current situation and given Japan's position at the frontier of issues, it is important for Japan to take the initiative in Asia in cooperating with other Asian nations in efforts to resolve and overcome various challenges.