”Doctor, is there a problem?” Patients invariably ask their doctors apprehensively when their bladder tumor patients are reviewed post-operatively, whether by ultrasound or cystoscopy. “No significant problems were found.” Shhh…a long breath out, “OK, it’s fine.” “Keep rechecking after a while.” “Okay.” But, “You’d better get a cystoscopy or CT”, “I have some unfortunate news, there’s another tumor in your bladder.” The bladder tumor has returned! Oh my God, 2012 is here and the earth is going to explode! Wait a minute! The earth is not going to explode, 2012 is just a myth! Don’t be afraid, it’s no big deal! For every bladder tumor patient, the last thing they want to hear is that their doctor says the tumor has come back. So, what should we do if the tumor has come back? This is the most urgent thing. Go to the hospital and have surgery immediately. Due to the characteristics of the disease, bladder tumor is easy to recur after radical total cystectomy. What to do if the tumor recurs is a matter of great concern to patients and their families. Tumor recurrence is not terrible, timely and appropriate treatment is the key. Cystoscopy, CT or MRI are indispensable, ultrasound and chest X-ray are also necessary. Because the patient has undergone one or more different types of surgery and has undergone bladder irrigation with anti-cancer drugs, the physician now needs to know the specifics of the tumor in the bladder: size, number, extent, depth of tumor infiltration, and pathological type of tumor. Although cystoscopy is painful, it can visually observe the lesion in the bladder cavity and take the tissue of the lesion for pathological examination for characterization; CT and MRI can understand the scope and depth of bladder lesion infiltration and whether there are pelvic lymph node metastases; abdominal ultrasound and chest X-ray can understand whether there are problems in other parts of the organs. This provides a comprehensive understanding of the disease and allows the most appropriate treatment plan to be chosen. The treatment of recurrent bladder tumors should be differentiated. 1, benign recurrence of bladder papilloma, transurethral electrical resection of bladder tumor can be performed again. After surgery, continue bladder perfusion with anti-cancer drugs, preferably with drugs not used before or alternate perfusion with different kinds of drugs to reduce the drug resistance of tumor cells. 2.If it is recurrence of bladder uroepithelial carcinoma, if the lesion is small, less in number and without infiltration of bladder muscle layer, transurethral bladder tumor electrical resection and laser, photodynamic therapy, thermotherapy, simple anti-cancer drug infusion, BCG infusion and other treatments can be done again. 3.For larger, recurrent and muscle layer infiltrated bladder uroepithelial carcinoma patients, radical cystectomy and pelvic lymph node dissection are recommended; for those who are not physically able to tolerate major surgery or unwilling to remove the bladder, transurethral bladder tumor electrodesis or partial bladder resection can be done according to specific conditions, and postoperative treatment is supplemented by systemic chemotherapy or radiotherapy, bladder anticancer drugs and BCG infusion. 4. If the tumor is large and has metastasis in other parts, comprehensive treatment is the main treatment. Chemotherapy or radiotherapy can be used first to reduce the tumor volume to create conditions for surgery, and then continue chemotherapy and radiotherapy after surgery. 5.Radical resection of the whole bladder plus pelvic lymph node dissection should be done for squamous bladder cancer and adenocarcinoma, followed by radiotherapy after surgery. 6.Patients who cannot undergo surgery and radiotherapy at advanced stage should be treated with a combination of surgery and radiotherapy to reduce pain and improve survival quality.