It is a very annoying and even alarming situation to find a growth in the bladder. This is because the most common cancer here is bladder cancer, one of the major tumors of the urinary tract. Bladder cancer occurs more in men than in women, and among the factors that can contribute to the development of cancer, smoking is the most definite and important. The possibility of bladder cancer should be considered when there is blood in the urine, pain in urination (different from common infections) and variation in urination pattern. I. DIAGNOSIS AND INITIAL TREATMENT Most bladder cancers are identified by symptoms such as blood in the urine, an ultrasound that reveals a mass in the bladder, and ultimately by cystoscopy, in which a urologist applies a special endoscope that allows him or her to see inside the bladder. When the tumor is found, most doctors nowadays will perform endoluminal resection of superficial tumors, and a satisfactory treatment can be achieved, which is called Transurethral Resection of Bladder Tumor (TURBT) II. Superficial or Invasive? After bladder tumor resection, the urologist and pathologist have to determine whether the tumor is superficial (limited to the mucosal layer of the bladder Ta-T1) or invasive (tumor invades more than the submucosa > T1). This is a clear-cut watershed; superficial tumors do not yet have the ability to metastasize beyond the bladder, while the latter have the potential to quickly metastasize to other parts of the body. The good news is that four out of five bladder cancers are superficial when first detected. Third, the risk of recurrence Although superficial bladder tumors don’t pose an immediate risk of metastasis, they can become invasive if left untreated. Cure can be achieved after complete removal of superficial tumors, however, the bladder is still at risk of regrowing tumors elsewhere. Once a superficial cancer occurs within the bladder mucosa, the chance of recurrent tumors thereafter is about 60-80%. Individual risk of recurrence includes tumor grade (degree of malignancy), number (single or multiple), and size of the primary tumor, among others. Monitoring for recurrence Once the superficial tumor is removed, the surgeon will perform regular cystoscopic reviews to monitor for recurrence. In the first two years after surgery, cystoscopy is usually done every three months, and if there is no recurrence, it can be extended to half a year in the following two years. after four years, there is still no recurrence, and then it can be reviewed every year. V. How to reduce recurrence? Doctors generally reduce the risk of recurrence by applying drugs, supplementing nutrients and improving lifestyle. VI. Drug therapy Drugs to fight against superficial tumor recurrence should be instilled into the bladder, which is called endoluminal instillation therapy. The drugs include chemotherapeutic drugs, (such as mitomycin C, epothilone, etc., which inhibit the division of malignant tumor cells) and immunosuppressive drugs (such as BCG, interferon, etc., which stimulate the body’s immune system and mobilize its own defense ability to fight against the tumor). According to the risk of recurrence, doctors will select different drugs for perfusion, and perfusion drugs can effectively reduce recurrence. VII. Lifestyle change Smoking is the most important factor associated with bladder cancer, more than 50% of bladder cancer is associated with it. The easiest thing to do is to quit smoking, you must! Studies have shown that the occurrence of bladder cancer decreases when you quit smoking. Certain chemical solvents increase the chance of bladder cancer, let your doctor know if you suspect any of these substances in your exposure environment. VIII. Nutrition We know more and more about the link between bladder cancer and nutrition. Current information supports an increase in fruits and vegetables and a decrease in animal protein intake. Also, evidence is accumulating that certain vitamin and nutrient supplements may reduce the recurrence of superficial bladder cancer.