Urethral Bladder Cancer Risk Factors: Age: >55 years Gender: Males > Females Smoking: Most common cause 3-4x increased risk 50% of cases Occupational Exposure: Dye factory workers Rubber industry Paint manufacturers Chronic Bladder Irritation: Urinary tract infections Bladder stones Indwelling catheters Exposure to certain chemicals (e.g., cyclophosphamide) Family History: Genetics: Mutations in P53, FGFR3, and other genes Pathogenesis: Multi-step process: Normal urothelium Hyperplasia Dysplasia Carcinoma in situ Invasive cancer Clinical Presentation: Hematuria: Most common symptom Can be painless or associated with dysuria Irritative voiding symptoms: Frequency Urgency Dysuria Obstructive symptoms: Difficulty urinating Weak stream Hesitancy Other symptoms: Back pain Weight loss Fatigue Diagnosis: Urinalysis: Microscopic hematuria Cystoscopy: Direct visualization of the bladder Biopsy for histological confirmation Imaging: CT scan MRI Ultrasound Staging: TNM system: T: Tumor size and depth of invasion N: Lymph node involvement M: Metastasis Treatment: Surgery: Transurethral resection of bladder tumor (TURBT) Partial or total cystectomy Chemotherapy: Intravesical chemotherapy Systemic chemotherapy Radiotherapy: External beam radiotherapy Brachytherapy Immunotherapy: Bacillus Calmette-Guerin (BCG) immunotherapy Targeted therapy: Checkpoint inhibitors Prognosis: Depends on stage and grade of the tumor Overall 5-year survival rate: ~80% Recurrence is common