Pathogenisis:
Bladder cancer is one type of malignancy arising from epithelial lining of the urinary bladder .Urinary bladder is less effected by lymphoma or sarcoma
Grades of Bladder Cancer transformation:
Once the bladder is diagnosed ,the diagnosis report determines the grade of effect by differentiating the cells from normal tissue.
And estimates the rate of growth .more than 90% of the bladder cancer are derived from transitional epithelium and hence this is called as Transitional cell carcinoma. The other 10% are squamous
Cell carcinoma, adenocarcinoma, sarcoma, and small cell carcinoma.

2) Causes of transformation :
Smoking is the major cause of bladder cancer and with other reasons like direct contact with carcinogens that are excreted in urine and also results from occupational exposure in workspace to carcinogens such as benzidine,2 –Napthylamine. people who consumes more than 2.5 l of water a day are less effected by bladder cancer.

3) The stages of disease occurrence
Stage indicates the extent to which the disease spread and if any other organs are effected by it .additional diagnosis is required to examine the spread to any other parts .
It has been divided in five stages
Stage0: Cancer cells are found only in inner lining of the bladder .This is called as Superfical cancer or Cancer in situ.
Stage1: Cancer cells are found deep in the lining of bladder ,but have not invaded the bladder muscle.
Stage 2: Cancer cells are present in the muscle of the bladder.
Stage 3: Cancer cells have spread through the bladder muscle into the tissues around the bladder such as prostrate in men or the uterus in women
Stage 4: Cancer has progressed further into abdominal cavity ,and may spreads into lymph nodes and the other organs in the body.

4) Several studies have revealed the bladder is one of the most responsive organs to induction of detoxification enzymes by extract .this was evident in human bladder cancer cells in vitro and in animals in vivo. Suplhoraphane and broccoli sprout extract were also observe to induce apoptosis and cell cycle arrest in human bladder cancer cells in vitro ,an anti cancer effect attributed to the sulphoraphane potential in the sprouts.

5) Gene expression
Information from a gene is used in the synthesis of a functional gene product this process is called Gene expression .The process of gene expression is used by all eukaryotes ,prokaryotes, possibly induced by viruses to generate the macromolecular machinery for life .The products in the gene process are proteins and sometimes functional RNA .several steps in the gene expression may be modulated, including the transcription ,RNA splicing ,translation and post translation modification of protein. Gene expression is the most fundamental which gives rise to the phenotype .

6) Phenotypic genetic changes
Many muscle-invasive tumors arise from pre-existing urothelial carcinoma in situ, a high-grade intraepithelial neoplasm and often exhibit alterations in the TP53, RB, and PTEN tumor suppressor genes .such tumors exhibit many karyotypic alterations, it is likely that additional mutations in oncogenes and tumor suppressor genes are involved in the transition from in situ tumors to invasive tumors. Deletion or mutations of the TP53 locus on chromosome 17p13 occurs frequently in urothelial carcinoma in situ.

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