The anticancer effects of HSE in BLCA may be attributed to its coordination of actions, inhibiting cell proliferation, migration, and invasion, inducing apoptosis, G0/G1 phase arrest, generating reactive oxygen species, causing MMP loss, and engaging the caspase protein family. These actions are likely mediated through the PI3K/AKT/FoxO3a and ER stress-mitochondrial pathways. Thus, our findings suggest that HSE is a promising novel therapeutic candidate for the prevention and treatment of BLCA.