Bladder cancer is the most common tumor of male urinary system in China, and its incidence rate is higher than that of kidney cancer and prostate cancer. Statistics show that about 50% of the unexplained hematuria in elderly patients is caused by bladder cancer, so the occurrence of hematuria should be highly valued and timely checked in hospitals for early diagnosis and treatment to obtain the best treatment effect. Bladder cancer can be roughly divided into three categories according to its clinical characteristics: non-muscle invasive bladder cancer, muscle invasive bladder cancer, and metastatic bladder cancer. We will give a brief introduction to the treatment of bladder cancer with these three types of tumors. Non-muscle invasive bladder cancer refers to cancer cells confined to the superficial bladder mucosal epithelial layer as well as the submucosal layer, without invading the deeper bladder muscle layer. This type of tumor is an early stage of bladder cancer, and the clinical treatment method is usually chosen from transurethral resection of bladder tumor (TURBT). The most important feature of this type of tumor is that it is easy to recur after surgery, and some studies have reported that the recurrence rate can be as high as 70%. To prevent the recurrence of bladder cancer after surgery, we generally adjuvantly administer bladder infusion chemotherapy. The drug is instilled into the bladder from the urethra and acts directly on the bladder mucosa. Foreign studies have shown that the best drug for recurrence prevention is BCG, but we do not have BCG for bladder instillation in China, and some patients have obtained BCG for bladder instillation through informal channels in China. The more widely used bladder instillation drugs in clinical practice are mitomycin C, pirarubicin, epirubicin, and hydroxycamptothecin, among others. For postoperative recurrent bladder cancer that is still a non-muscle invasive tumor, there is also the option of re-electrolysis. In about 15% of patients with recurrence, the tumor progresses to a muscle-invasive tumor, and then electrosurgery is no longer indicated. Muscle-invasive bladder cancer is cancer that has grown deep into the muscle layer of the bladder. The clinical characteristic of this type of bladder tumor is that it is prone to metastasis, so the treatment for this type of tumor is usually a total cystectomy with pelvic lymph node dissection. After removal of the bladder one is faced with a problem of urinary diversion. The bladder is an organ for storing and excreting urine, what is the way to excrete urine after total cystectomy? In the history of medical development, there have been many surgical procedures, some of which have been eliminated and some of which are still in use today, while some new procedures are being used in clinical practice. The following is an introduction to the two most widely used surgical methods in clinical practice, one is the ileal cystectomy (Bricker procedure), and the other is the in situ neocystectomy. The first method is called simple and involves taking a small section of ileum (about 15 cm long) and anastomosing one end with both ureters, and making a stoma in the right lower abdomen at the other end to drain urine out of the body. This procedure is simpler and has fewer postoperative complications, but the disadvantage is that an ostomy bag needs to be attached to the abdominal wall and that bag needs to be changed regularly. The second method is the in situ neobladder, which allows you to choose an ileum or colon to make a new bladder that is placed in the place of the original bladder. This procedure is more complex and has relatively more postoperative complications, such as urinary incontinence, recurrence of urethral tumors, hydronephrosis, and metabolic disorders. The biggest advantage of this procedure is that it ensures the patient’s ability to urinate in a positive position after surgery, which means that he or she can urinate in a standing position like a normal patient and has a better quality of life. The new bladder has no corresponding innervation and voiding needs to be done with the assistance of abdominal pressure. For patients with tumors at the bladder neck or urethra a total urethral resection is required and therefore in situ neobladder surgery is not indicated. Invasive bladder cancer is prone to metastases and approximately 50% of patients will still develop tumor metastases after total cystectomy. A minority of patients have metastatic bladder cancer at the time of first diagnosis. Metastatic bladder cancer is an advanced tumor that has lost the chance of radical cure, and the aim of treatment is to prolong life and improve quality of life. The main treatment for metastatic bladder cancer is systemic chemotherapy. A few points of clarification: The above three types of bladder cancer treatment methods are outlined in a rather simple way, and the main purpose is to give a rough idea to all patients. There are often some exceptions in clinical situations, which need to be analyzed on a case-by-case basis to choose the appropriate treatment plan. For example, for muscle layer non-invasive bladder cancer, in most cases we choose transurethral resection, but for recurrent superficial tumors, tumors with very poor pathological differentiation, and superficial tumors accompanied by carcinoma in situ are suitable for total cystectomy. For example, for muscle-invasive bladder cancer, we usually choose total cystectomy, but if the patient is in poor general condition or has severe cardiopulmonary insufficiency and cannot tolerate such a major surgery, transurethral resection can also be chosen according to the situation, together with postoperative radiotherapy and chemotherapy to improve the efficacy. Therefore, each patient should choose a treatment plan that is suitable for him or her according to the characteristics of his or her condition, and should choose carefully after careful consultation with the doctor. Finally, it should be pointed out that one should not believe in certain advertisements or so-called ancestral recipes or certain Chinese herbal medicines as the main treatment for bladder cancer. So far, no single herbal medicine or folk remedy has been found to be able to cure bladder cancer. Today, with the rapid development of oncology and the rapid changes in science and technology, we still have not found any Chinese herbal medicine that can cure tumors. Chinese herbal medicine may be somewhat helpful for health maintenance, but it has no significant efficacy in curing diseases, especially in treating tumors. We have encountered many patients who refused surgery because they believed in TCM, and as a result, they delayed their disease and lost the chance of treatment. Therefore, we remind you that you must believe in science. Whether TCM belongs to the realm of science or not is still under debate in the academic world!