found in plants of the family Aristolochiaceae, also causes DNA mutations and is a cause of liver, urothelial and bladder cancers. Occupational exposure to certain chemicals is also a risk factor for bladder cancer. This can include aromatic amines (aniline dye), polycyclic aromatic hydrocarbons, and diesel engine exhaust. Carcinoma Carcinoma is a type of cancer that occurs in epithelial cells. Transitional cell carcinoma is the leading type of bladder cancer, occurring in 9 out of 10 cases. It is also the leading cause of cancer of the ureter, urethra, and urachus, and the second leading cause of cancer of the kidney. Transitional cell carcinoma can develop in two different ways. Should the transitional cell carcinoma grow toward the inner surface of the bladder via finger-like projections, it is known as papillary carcinoma. Otherwise, it is known as flat carcinoma. Either form can transition from non-invasive to invasive by spreading into the muscle layers of the bladder. Transitional cell carcinoma is commonly multifocal, more than one tumor occurring at the time of diagnosis. Transitional cell carcinoma can metastasize, or spread to other parts of the body via the surrounding tissues, the lymph system, and the bloodstream. It can spread to the tissues and fat surrounding the kidney, the fat surrounding the ureter, or, more progressively, lymph nodes and other organs, including bone. Common risk factors of transitional cell carcinoma include long-term misuse of pain medication, smoking, and exposure to chemicals used in the making of leather, plastic, textiles, and rubber. Transitional cell carcinoma patients have a variety of treatment options. These include nephroureterectomy, or the removal of kidney, ureter, and bladder cuff, and segmental resection of the ureter. This is an option only when the cancer is superficial and infects only the bottom third of the ureter. The procedure entails removing the segment of cancerous ureter and reattaching the end. Patients with advanced bladder cancer or disease, also often look to bladder reconstruction as a treatment. Current methods of bladder reconstruction include the use of gastrointestinal tissue. However, while this method is effective in improving the function of the bladder, it can actually increases the risk of cancer, and can cause other complications, such as infections, urinary stones, and electrolyte imbalance. Therefore, other methods loom in the future. For example, current research paves the way for use of pluripotent stem cells to derive urothelium, as they are highly and indefinitely proliferative