Bladder cancer is a disease that occurs when abnormal, cancerous cells form in the bladder—the organ that holds urine. There are several types of bladder cancers. The most common type is called transitional cell carcinoma, accounting for 90% of all bladder cancers. It begins in the cells lining the inside of the bladder. Another type, squamous cell carcinoma, is cancer that begins in thin, flat cells called squamous cells. These may develop in the bladder after lasting infection or irritation. Adenocarcinoma is a relatively rare type of bladder cancer and may be caused by long-term inflammation or irritation. Cigarette smoking is the greatest risk factor for bladder cancer. Workers in certain industries, such as rubber, textile, printing, painting, and hairdressing, may be exposed to dyes and certain chemicals that put them at higher risk. The risk for bladder cancer increases with age and is more common in men than in women. Whites are more likely to develop the disease than other races. Other risk factors include chronic bladder infections or bladder stones and a personal or family history of bladder cancer. Bladder cancer can be diagnosed in a number of ways. Your doctor will review your complete medical history and may perform a rectal or vaginal exam to check for tumors. Your doctor may also perform a cystoscopy, an exam in which a flexible tube and viewing device is inserted through the urethra to examine your bladder. Samples of your bladder tissue (called a biopsy) may be removed for examination under a microscope. You may have a urine test to check for blood, chemicals, tumor biomarkers, bacteria, and cells. The urine may be examined under a microscope or cultured in a dish to check for infection. Cancerous cells may be detected in the urine using the microscope. Sometimes imaging tests are used to detect bladder cancer. A computed tomography scan (also called a CT or CAT scan) uses a combination of X-rays and computer technology to produce detailed images of the body from different angles. These images can provide information about the size, shape, and location of a tumor. An intravenous pyelogram, or IVP, is a series of X-rays of the kidney, ureters, and bladder. A contrast dye is injected into a vein. The kidneys remove the dye from the bloodstream and pass it through the ureters and bladder. This helps to clearly outline these organs in X-rays to help detect any tumors. If bladder cancer is diagnosed, you may need more tests to find out the cancer’s stage. The stage indicates how widespread the cancer is and if other body parts or organs are affected. This helps your doctor determine the best course of treatment for you. Treatment options depend on the stage of the cancer, as well as your age, general health, and personal preference. Most people with bladder cancer have superficial and noninvasive tumors. This means the tumors have not grown into the main muscle layer of your bladder. Treatment for these tumors is often very effective with an excellent prognosis. Other bladder cancers invade deep into the bladder wall and muscle. There is a greater risk for the cancer spreading into other tissues in these cases. There are four main types of treatment for bladder cancer: surgery, radiation therapy, chemotherapy, and biologic therapy. Surgery may remove tumors, the affected parts of the bladder, or the bladder and surrounding lymph nodes and organs. Radiation therapy uses high-energy rays to kill or shrink cancer cells. Chemotherapy uses anticancer drugs to kill cancer cells. Biological therapy uses the body’s own immune system to fight cancer. Depending on the stage, bladder cancers may be managed with a single therapy or a combination of treatments.