Bladder cancer, also known as urinary bladder cancer, urinary bladder carcinoma or bladder carcinoma, is a cancer that can occur mainly in older men. It develops mostly in the mucous membrane of the urinary bladder and can become a malignant tumor as it progresses. If bladder cancer is detected in time, the chances of cure are favorable, especially through bladder endoscopy. Typical signs in bladder cancer are usually blood in the urine and burning pain when urinating.
What is bladder cancer?
Schematic diagram showing the anatomy and structure of the urinary bladder with bladder cancer. Click to enlarge. Bladder cancer refers to a type of cancer in which malignant tumors occur in the mucosa of the urinary bladder, which can grow deep into the bladder wall and subsequently spread to surrounding organs. Bladder cancer is also known as urinary bladder carcinoma or bladder cancer. Men are about three times more likely to develop bladder cancer than women. Bladder cancer is thus one of the most common cancers in men and three percent of all malignant cancers are tumors of the bladder. The likelihood of developing bladder cancer increases with age. Therefore, bladder cancer is very rarely found in people under the age of forty and usually develops after the age of sixty to eighty.
Causes of bladder cancer
Bladder cancer is promoted by a wide variety of factors, but so far the exact causes of bladder cancer are unknown. One of the biggest risk factors for bladder cancer is long-term cigarette use. Another cause of bladder cancer can be chronic diseases of the urinary bladder, such as cystitis or bladder stones. Bladder cancer is also promoted by frequent contact with various chemicals, such as aromatic amines. Thus, bladder cancer also occurs in many cases in people who are or have been occupationally exposed to such chemicals over long periods of time, for example in rubber or paint manufacturing. Abuse of various painkillers containing phenatecin is also considered a risk factor for bladder cancer. Bladder cancer can also be caused by infestation of parasites found in tropical regions. In addition, there is a link between the consumption of artificial sweeteners and bladder cancer.
Symptoms, complaints and signs
Bladder cancer initially causes few, nonspecific symptoms. The first sign is often painless bleeding with reddish-brown urine. In advanced stages, many patients experience bladder spasms, pain during urination, and an increased urge to urinate, but with little urine passed. The pain is usually sharp and may radiate to the flanks. Enlarged lymph nodes and venous or lymphatic congestion are also typical symptoms. If the tumor presses on surrounding tissue or organs, pressure pain and occasionally sensory disturbances and paralysis in the affected area may occur. As the disease progresses, bone pain and functional disturbances of the bladder may also occur. Eventually, complete urinary retention occurs, followed by other symptoms. Typical symptoms include urinary rupture and fever, which increases in intensity as the urinary retention progresses. Kidney pain, colic and cramps may also occur in the course of untreated bladder cancer. Since all of the symptoms are also possible with cystitis and similar conditions, a definitive diagnosis can only be made if multiple signs occur and do not resolve with the usual treatment measures. Due to the rather unspecific symptoms, the family doctor or a urologist should be consulted already at the first symptoms.
Course
Bladder cancer is announced in most cases by the appearance of bloody urine. The blood may be visible to the naked eye in some cases, but may not be detected until a urine test is performed. Pain rarely occurs, but there may be a burning sensation during and after urination. An increased urge to urinate can also be observed in bladder cancer. Since these symptoms can also indicate a harmless disease, a urologist should be consulted if one or more of these symptoms occur.The physician can determine whether bladder cancer is present by means of various examinations, such as cystoscopy, ultrasound, protein pattern analysis or tissue samples. In addition, if a large tumor already exists, patients may experience complete urinary retention.
Complications
The earlier bladder cancer is detected and thus treated, the better the affected person’s chances of survival and the lower the risk of complications. Metastases, i.e. daughter tumors that can spread from the tumor to other organs via the bloodstream, usually form only when the bladder cancer has reached the muscular layer of the urinary bladder. Due to the good blood circulation, this offers a wide attack surface for metastases. This also reduces the chances of survival. Often, after surviving a carcinoma, another one occurs, which is why follow-up care and regular examinations are very important. Chemotherapy can reduce the risk of recurrence. The various forms of therapy also carry some risks. Surgery may result in less urine being able to be held in the bladder. In addition, after complete removal, women may not be able to give birth and men may be impotent. Pain occurs in the days following surgery, for which appropriate medications are prescribed. Chemotherapy of the bladder may cause kidney damage in addition to normal irritation and discomfort. Side effects of immunotherapy include blood in the urine and flu-like symptoms that can range from simple lassitude to fever and diarrhea.
- Injury to the urethra or ureter,
- Increased bleeding tendency,
- Impairment of adjacent organs.
Because urinary stones have a high recurrence rate, successful removal does not guarantee a lifelong cure. Anyone who once had bladder stones, should therefore pay special attention to prevention.
When should you go to the doctor?
Bladder cancer manifests itself at the beginning only by little or no discomfort, wodruch it is difficult to detect. In addition, harmless urinary tract diseases can also cause similar symptoms. Once the tumor in the bladder has been diagnosed and treated, it is important to consult a specialist in urology immediately if there are any more blood in the urine or pain when urinating. Symptoms such as urinary retention as well as disturbances when emptying the bladder are also reason to consult a urologist. If the tumor has already spread to other organs, it is necessary to consult other specialists as well. In addition to or instead of surgical treatment, radiation therapy may be an alternative. A radiologist will then decide on this treatment. In addition, radiologists also assess the location of the tumor by means of special examinations, such as computer tomography or magnetic resonance imaging. In the event that the bladder cancer is so advanced that there is no chance of cure, a specialist in pain therapy/palliative medicine will take over further treatment.
Treatment and therapy
Bladder cancer, if diagnosed early, can be treated well. The treatment that is initiated depends on the size and location of the tumor. Bladder cancer is divided into superficial and aggressive tumors. Superficial tumors can be removed by a rather uncomplicated surgery. In many cases, however, bladder tumors can recur even after successful surgery. For this reason, regular examinations are performed and medication is prescribed after surgery. In the case of aggressive tumors that have already grown into the bladder wall and beyond, a larger operation is usually necessary. Here, the entire bladder is removed and the urinary diversion is rerouted. In some cases, the prostate must be removed in men and parts of the uterus in women. The operations are sometimes either accompanied or replaced by chemotherapy. Bladder cancer can be cured, especially if caught early.
Outlook and prognosis
The chances of a patient with bladder cancer being cured depend on several factors. If the bladder cancer is superficial, the patient has the best chance of cure, provided that the necessary therapy is administered promptly.In addition, a high chance of cure results if the bladder is removed as soon as possible when bladder cancer is present and the tumor has penetrated the wall of the bladder the least. These are the cases where there is a very good chance of cure. If the cancer spreads, the chances of cure are low. Spreading is the process in which the cancer affects the lymph nodes and there is also the formation of metastases in organs other than the bladder. In this case, chemotherapy is usually given, but it is often used to stop the progression of the cancer rather than to cure it. The therapies used for metastases aim to provide the patient with relief. This includes relieving the patient of pain as much as possible. In summary, the earlier the cancer is detected and the earlier the necessary therapy is initiated, the higher the patient’s chances of recovery.
This is what you can do yourself
In the case of bladder cancer, all treatment steps and accompanying measures should be worked out in cooperation with the physician. In addition to this, those affected can improve their general well-being through a number of home remedies and tricks. First of all, dietary measures are an option. Foods such as cabbage, olive oil or red wine inhibit the formation of cancer and promise good healing chances, especially in combination with conventional medical therapy. In order to protect the bladder mucosa, urinary tract, and kidneys, patients should also drink enough fluids. It is also advisable to eliminate stimulants such as alcohol and caffeine from the diet and, if necessary, to stop smoking. Which diet is suitable in detail can be determined in the course of a nutritional consultation. A corresponding consultation, which is offered in many hospitals and rehabilitation clinics, also provides information about possible sports activities with bladder cancer. After a longer period of illness, regular exercise can usually improve the quality of life. The way back into everyday life and dealing with the disease can also be made easier by talking to a therapist. The attending physician can point out further possibilities for self-help during bladder cancer.
