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Bladder cancer is a malignancy arising from the urothelial lining of the bladder, with transitional cell carcinoma being the most common type. It typically presents with painless hematuria and has strong associations with smoking and occupational chemical exposures.
Carcinogenic substances in urine cause chronic irritation and DNA damage to the bladder's transitional epithelium, leading to dysplastic changes and eventual malignant transformation. The majority of bladder cancers are non-muscle invasive at diagnosis, though progression to muscle-invasive disease carries significant metastatic potential.
Diagnosis requires cystoscopy with biopsy for tissue confirmation, while imaging studies assess local invasion and distant metastases. Treatment approach depends on staging, ranging from transurethral resection for superficial tumors to radical cystectomy with urinary diversion for muscle-invasive disease.