Definition: A type of cancer that occurs in the transitional epithelium – the tissue that lines the inner part of the urinary system including the renal pelvis, ureters, bladder, and parts of the urethra. Epidemiology: Most common type of bladder cancer, accounting for over 90% of cases. More frequent in men and in those aged over 60. Risk Factors: Smoking: Major risk factor, increasing risk up to threefold. Exposure to certain chemicals like aniline dyes and aromatic amines. Previous radiotherapy or chemotherapy (especially cyclophosphamide). Chronic bladder irritation, e.g., from recurrent urinary infections or long-term catheter use. Clinical Presentation: Painless hematuria: Most common symptom. Frequency, urgency, and dysuria – symptoms similar to UTI. Possible flank pain or mass if upper urinary tract involvement. Investigations: Cystoscopy: Direct visualisation of the bladder interior. Urine cytology: Examination of urine under the microscope to detect cancer cells. Imaging: CT urogram or ultrasound to assess for spread and upper tract involvement. Management: Non-invasive (Ta, T1): Transurethral resection of bladder tumour (TURBT). Followed by intravesical chemotherapy or BCG to reduce recurrence risk. Invasive (T2+): Radical cystectomy (removal of the bladder). Neoadjuvant or adjuvant chemotherapy. Prognosis: Depends on stage and grade at diagnosis, but TCC tends to have a high rate of recurrence. Regular surveillance with cystoscopy is essential.