Diagnosis
Bladder cancer can be diagnosed with certainty by so-called cystoscopy. A thin tube is inserted through the urethra into the bladder under local anesthesia, so that the inside of the bladder can be viewed enlarged. Unfortunately, bladder cancer as such does not have any specific parameters that can be examined in a blood count.
However, the examination of a urine sample can provide indications of a malignant change in the bladder. In any case, the cystoscopy is always followed by follow-up examinations, such as an X-ray examination in which the kidneys, renal pelvis and ureters are examined for malignant neoplasms. Magnetic resonance imaging and computed tomography of the lungs and abdomen also follow in the case of a bladder cancer finding, in order to clarify how far the cancer has spread. With ultimate certainty, however, a cancer of the bladder can only be diagnosed when a so-called biopsy (a tissue sample) of the cancerous growth has been taken during a cystoscopy and examined under the microscope by special specialists.
Epidemiology
With regard to the frequency distribution, it can be said that bladder cancer is relatively rare with only 3% of all cancers. Men are almost three times more likely to develop the disease than women – in absolute numbers: Approximately 20,000 men and 8,000 women develop bladder cancer annually. The vast majority of bladder cancer patients are older than 65 years; just 5% are younger than 45 years. Bladder cancer can be divided into superficial bladder carcinomas, which are restricted to the inner tissue layers of the bladder wall, and so-called infiltrating bladder carcinomas, which also affect the bladder muscles or other organs. About 80% of diagnosed bladder cancers are superficial bladder carcinomas.
Symptoms
A typical first symptom of bladder cancer is painless bleeding from the bladder, which occurs in the vast majority of patients.However, it is treacherous that only a comparatively heavy bleeding is noticed by a reddish-brown coloration of the urine. This is often preceded by smaller bleedings, which, however, did not result in a discoloration of the urine and – since they are not visible to the naked eye – go unnoticed. The diagnosis of bladder cancer is also made more difficult by the fact that it also manifests itself through symptoms such as the frequent urge to urinate or pain when urinating. However, since these are also typical of a harmless cystitis, bladder cancer can be overlooked. Symptoms such as side pain (due to the proliferating tumor, the urine accumulates back to the kidney), weight loss and anaemia are already signs of a more advanced stage of cancer.
