there are multiple issues for your patient, including COPD which is a breathing disorder seen in smokers. Also there seems to be a
kidney issues which may be secondary to the tumour in bladder. And then third issue - the bladder tumour itself.
Next Steps
In order to answer your questions - you need to visit an urooncologist urgently and a nephrologist too.
Secondarily you will need the assistance of a pulmonologist as well.
Health Tips
Stop smoking at the earliest...