Renal cell carcinoma (RCC) and bladder cancer (BC) are among the most frequently diagnosed urinary system cancers worldwide. They are characterized by high mortality and recurrence rates. In response to the rising incidence and mortality rates, scientists are exploring innovative diagnostic and therapeutic methods. Metabolomics, which analyzes metabolite levels, may enable early diagnosis and monitoring of therapy progress. Compared to other omics technologies, it focuses on the outcomes of metabolite activity, providing a unique perspective on processes occurring in cancer cells. Metabolomic analyses utilize techniques such as mass spectrometry. These methods allow the identification of biomarkers and precise determination of the chemical composition of biological samples. However, the most commonly used method is liquid chromatography-mass spectrometry (LC-MS), which enables the most comprehensive screening of cancer metabolomes. Recent studies show significant progress in recognizing characteristic metabolites associated with urological cancers, although this area remains partially unexplored. Research on circulating metabolites, especially those present in easily accessible samples like blood or urine, demonstrates promising potential in clinical practice. Study results reveal differences in metabolic profiles between various stages of cancer development, which may have clinical significance. The future of this field involves an increasing number of clinical cohorts, standardization of sample preparation, and further improvements in instrument sensitivity and speed. LC-MS-based metabolomics has the potential to contribute to the improvement of diagnostics, therapy, and the quality of life of patients with some urological cancers. However, challenges, such as the lack of uniform methodologies and understanding of metabolite determinants, require further research and innovation.
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