“People who smoke are three to four times more likely to develop bladder cancer than non-smokers. This type of cancer is more common in men than in women. The most common symptom of bladder cancer is blood in urine. Other symptoms include a burning sensation while passing urine and an urge to urinate frequently. If bladder cancer reaches an advanced stage, symptoms can include bone pain, pelvic pain and weight loss.” This information was shared by Dr. Khurram Mir, Consultant Urologist at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore. Each year, the month of May is observed as the Bladder Cancer Awareness Month around the world, which culminates in the World No Tobacco Day on May 31. In this regard, Dr Khurram Mir said that generally, people think that smoking only causes lung cancer but in fact, smoking causes many different types of cancers including bladder cancer. Tobacco is harmful in all forms which in Pakistan include water-pipe (hukkah), betel leaf with areca nut (paan), gutka, and niswaar. Consumption of any of these tobacco products can increase the risk of bladder cancer by about 30 percent. This risk is normalized only after nearly twenty years of quitting tobacco. People who smoke for many years, harmful chemicals pass into their bloodstream and are filtered by the kidneys into urine. Since the bladder is repeatedly exposed to these harmful chemicals, it can cause changes to the cells of the bladder lining, which may lead to bladder cancer. Another risk factor for bladder cancer is related to certain industrial chemicals. People who work in industries producing rubber, leather, textiles, and paint products as well as printing companies are at a higher risk of bladder cancer. Therefore, it is important for all such people to get annual health screenings. The type of treatment depends on the stage at which bladder cancer is diagnosed. If diagnosed at an early stage, it can be usually treated with surgery alone. In an advanced stage, treatment requires chemotherapy and radiation therapy.