Every year, about 30,000 people in Germany develop bladder cancer (bladder carcinoma). Men are affected about twice as often as women. Currently, the average age of onset is 74 years for women and 72 years for men. Bladder cancer is often diagnosed at a late stage because tumors in the bladder are hardly noticeable for a long time. Symptoms that may indicate bladder cancer are blood in the urine or pain when urinating. However, such symptoms can also occur with a harmless bladder infection. If bladder cancer is detected at an early stage, the chances of cure are usually good.
Causes of bladder cancer
In bladder cancer, a malignant tumor forms in the urinary bladder. Scientists continue to disagree about exactly why such bladder tumors develop. However, there are some factors that significantly increase the risk of developing bladder cancer. As with lung cancer, smoking plays a central role in the development of bladder cancer, because cigarette smoke contains a wide variety of carcinogenic substances. When smoked, the harmful substances first enter the blood, then the kidneys and finally the bladder with the urine. Since the urine usually remains there for a long period of time, the substances can develop their damaging effect particularly well in the bladder. According to experts, between 30 and 70 percent of all bladder cancers are caused by smoking.
Chemical substances increase bladder cancer risk
In addition, contact with certain chemical substances in particular can significantly increase the risk of bladder cancer. Aromatic amines are considered particularly dangerous. Aromatic amines are used, for example, in the chemical and pharmaceutical industries, the rubber industry, the textile industry, and in leather processing. In some occupational sectors, bladder cancer is therefore recognized as an occupational disease. In the meantime, the most dangerous substances are no longer used in the affected occupations, but since bladder cancer develops over a very long period of time, cases still occur. In addition, chronic cystitis can also increase the risk of developing bladder cancer. Similarly, people who have frequently resorted to the now-defunct pain medications containing the active ingredient phenacetin also have an increased risk of bladder cancer.
Symptoms of bladder cancer
The first signs of cancer of the bladder are mostly uncharacteristic, as they could also indicate other diseases. However, this is precisely why you should see a doctor early if you have certain symptoms, so that you can rule out a diagnosis of bladder cancer. The following symptoms may be the first signs of bladder cancer:
- Blood in the urine: blood is present in the urine of about 80% of patients who have bladder cancer. Blood in the urine is not always visible at first glance, and sometimes the urine is just darker in color than normal. In women, blood in the urine is often mistakenly blamed on menstruation or menopause.
- Flank pain: pain in the flank that has no other obvious cause can indicate bladder cancer, but also kidney cancer.
- Pain during urination: Symptoms that we would initially tend to associate with chronic cystitis can also be signs of bladder cancer. These include, for example, pain when urinating, frequent urge to urinate, as well as disturbances in emptying the bladder.
Bladder cancer: diagnostics
If you notice symptoms in yourself that indicate bladder cancer, you should definitely see a doctor. He will first have a personal conversation with you, in which you can describe your symptoms and inform the doctor about previous illnesses and possible occupational risk factors. If the conversation strengthens the suspicion that bladder cancer may be present, the doctor will perform a thorough physical examination. The purpose of this examination is to determine whether a bladder tumor is actually present or whether there is a harmless cause behind the symptoms. To this end, the attending physician will first examine the blood and urine. Depending on the need, an X-ray examination of the urinary tract, an ultrasound examination or a cystoscopy may then be necessary. During a cystoscopy, the doctor can specifically search the bladder for suspicious areas and, if necessary, take tissue samples directly.If, after the cystoscopy, it is suspected that a tumor has grown in the bladder, the patient’s urine is examined again – this time for malignant cells. If such altered cells are found in the urine, there is a high probability that a bladder tumor is present.
Precise examination of the bladder tumor
Once it is considered certain that the patient has bladder cancer, the doctor will check how far the disease has progressed and whether the cancer has already spread, that is, whether metastases have formed. In order to obtain more detailed information about the tumor, tissue is once again taken from the bladder and examined. A computed tomography (CT) scan is also performed to show the location and size of the tumor as well as possible metastases. A CT also provides the attending physician with information on whether the tumor can be surgically removed at all. If there is a suspicion that metastases have formed, a magnetic resonance imaging (MRI) or a skeletal scintigram can also be performed in addition to ultrasound and CT. Following the examinations, the attending physician will work with the patient to determine the best treatment for him or her.
