Bladder cancer most commonly originates from the urothelial cells lining the inside of the bladder and is one of the most frequently diagnosed urological cancers. It predominantly affects older adults and is more common in men, although women often present with more advanced disease due to delayed diagnosis. Smoking is the most significant risk factor, along with occupational exposure to industrial chemicals, chronic bladder irritation, and prior radiation exposure.

Early bladder cancer often presents with painless blood in the urine, urinary frequency, urgency, or discomfort during urination. As the disease progresses, symptoms may include pelvic pain, urinary obstruction, weight loss, or bone pain in metastatic cases. Prompt evaluation of urinary symptoms is critical for early detection and improved outcomes.

Medical oncology plays a central role in the treatment of muscle-invasive, advanced, and metastatic bladder cancer. Systemic chemotherapy is commonly used either before surgery to reduce tumor burden or after surgery to decrease recurrence risk. In advanced disease, chemotherapy remains a key treatment modality for controlling tumor spread and alleviating symptoms.

Immunotherapy has significantly transformed bladder cancer management, particularly for patients with advanced or treatment-resistant disease. Immune checkpoint inhibitors help activate the immune system to recognize and attack cancer cells, offering durable responses in selected patients. Molecular testing increasingly guides treatment selection and sequencing.

For metastatic bladder cancer, medical oncology focuses on prolonging survival while maintaining quality of life. Treatment decisions are individualized based on disease extent, renal function, prior therapies, and patient fitness. Supportive oncology care addresses pain, urinary symptoms, fatigue, and treatment-related side effects.

In Dubai and the UAE, bladder cancer care follows international oncology guidelines and emphasizes multidisciplinary collaboration between medical oncologists, urologists, radiologists, and palliative care teams. Advances in systemic therapy continue to improve outcomes for patients with this challenging malignancy.