Inclusion Criteria:

- Pathological diagnosis of transitional cell carcinoma of the urothelium of at least
T2-4, Nx, Mx stage. Mixed histologies will be allowed (e.g. squamous
differentiation) as long as a transitional cell component is present.

- Clinical plans for surgery (with or without chemotherapy), radiation therapy, or
chemotherapy.

- Participants must not have any condition which in the investigator's opinion may
compromise the feasibility of completing the study.

- Subject must be 18 years of age or older

- Subject must be willing to have up to 4 peripheral blood samples obtained over a 6
month period of study.

- Prior therapies for bladder cancer will be allowed if patient currently has
muscle-invasive or metastatic bladder cancer despite the previous treatments.

- Predicted life expectancy of > 12 weeks.

Exclusion Criteria:

- Subjects who are unwilling or unable to comply with the study guidelines as
determined by the principal investigator.