Bladder cancer is strongly linked to environmental and lifestyle exposures, particularly cigarette smoking, which accounts for the majority of cases. Occupational exposure to dyes, chemicals, and chronic irritation (such as long-term catheters or infections) also increase risk.

The hallmark symptom is painless hematuria, either visible or microscopic. Irritative urinary symptoms like frequency, urgency, and dysuria are also common. Diagnosis is made using cystoscopy, urine cytology, and imaging (CT urography).

Treatment depends on stage. For non-muscle invasive bladder cancer (NMIBC), transurethral resection of bladder tumor (TURBT) is followed by intravesical therapy (BCG or chemotherapy) to reduce recurrence and progression. Close surveillance with repeat cystoscopy is essential.

For muscle-invasive bladder cancer (MIBC), the standard treatment is radical cystectomy with urinary diversion (ileal conduit, neobladder, or continent reservoir). Robotic cystectomy offers minimally invasive benefits. In selected cases, bladder-sparing trimodal therapy (TURBT + chemotherapy + radiotherapy) may be considered.

Metastatic bladder cancer is treated with systemic therapy. Platinum-based chemotherapy has been the backbone, but immunotherapy and targeted agents are transforming outcomes.

Bladder cancer has one of the highest recurrence rates among cancers, making lifelong follow-up critical. With advanced techniques and immunotherapy, long-term survival continues to improve.