Bladder cancer is an insidious tumor disease. The tumor in the bladder can grow for years without causing any symptoms and without the affected person noticing anything. However, the same applies to bladder cancer as to many other cancers: the earlier it is detected, the better the chances of treatment and cure.
Last revised April 2020
Contents
Suspicious symptoms
If suddenly, as if out of the blue, the urine is discolored bloody once or repeatedly, there is an urgent suspicion of bladder cancer. Unfortunately, this leading symptom does not occur at the beginning of the disease. Other symptoms that suggest a bladder tumor include difficult, sometimes painful urination and frequent urges to urinate. However, the symptoms can also be misinterpreted as cystitis. Thus, there is a risk that the diagnosis of bladder tumor is delayed for months. This is all the more fatal because there are no real early symptoms of bladder cancer.
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Blood in the urine is a warning sign. Affected persons should definitely have the cause clarified. Laboratory tests help.
If bladder infections recur, this may indicate bladder cancer.
Bladder cancer risk factors
Men are two and a half times more likely to develop bladder cancer than women. On the other hand, the disease is more often fatal in women. Tumors of the bladder and upper urinary tract are the best-studied types of cancer in connection with risk substances from the Working Environment. According to this, workers in the chemical, rubber, dye and leather industries, as well as gas station attendants, hairdressers and long-distance truck drivers are particularly at risk. In addition, in particular Smokers and people who have been painkillers take, an increased risk of cancer. Furthermore favor chronic bladder infections and Urinary flow disorders the development of bladder cancer. The cancer-causing substances are absorbed through the skin or with the air we breathe in the course of industrial activities and smoking, and are subsequently excreted in the urine. This is how they come into contact with the urinary bladder. The time span until a tumor forms can be 15 to 30 years.
Bloody urine – what to do?
The cause of blood in the urine – even if it occurs only once – must be clarified by a urologist. A standard diagnostic procedure is defined for this purpose: a Urinalysis, a Urine culture to detect a possible infection and a Ultrasound examination of the urinary tract. For further clarification a cystoscopy may be necessary. This allows the urologist to search the urethra and bladder for tumors. As an additional examination method, the Urine cytology available. A urine sample is examined under a microscope to look for malignant cells. However, this method has the disadvantage that it often leads to false results, as it has only a very low sensitivity for early tumor detection.
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Danger in everyday working life: hairdressers, long-distance truck drivers, gas station attendants, workers in the chemical, rubber, dye and leather industries are at risk of developing a bladder tumor.
The cancer-causing substances enter the body through the skin or with the breath and come into contact with the mucous membranes of the urinary bladder through the urine. It can take 15 to 30 years for a tumor to form.
Diagnosis with tumor markers
For early diagnosis of bladder cancer and monitoring after bladder cancer treatment, there are various urine tests that are considerably more sensitive than urine cytology. In addition to instrument-based tests, there are rapid tests that detect various bladder cancer markers (proteins, antigens). One of the main advantages of urine tests is that they can be carried out easily and without any stress for the patient. Thus, they are suitable for screening, diagnosis and therapy monitoring of bladder cancer.
Screening tests desirable for high-risk groups
Because the chance of developing bladder cancer is mainly due to risk factors, it makes sense to perform a risk check before screening to minimize the number of possible false test results. This is why it is especially important for high-risk groups such as smokers and certain groups of employees (see above) to undergo regular screening tests. So far, however, such tests have only been reimbursed by private health insurance companies.
Early diagnosis improves prognosis
How important it is to diagnose the bladder tumor as early as possible is proven by the figures: In up to 30 percent of patients, a stage of cancer is already present at diagnosis in which the cancer has grown into the bladder wall and thus has an unfavorable prognosis. Early diagnosis and appropriate therapy can prevent fatal consequences as well as serious operations, such as the complete removal of the urinary bladder.
Therapy monitoring with biomarkers
Marker-based tests also help to monitor therapy, since the frequency of relapses is relatively high. In up to 70 percent of patients, tumors reappear after removal of the cancer through the urethra. By using tumor marker tests, especially for low-grade tumors, the intervals between unpleasant bladder examinations can be increased.
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Cancer cells: They produce increased amounts of certain proteins,which are important for diagnosis as tumor markers.
Early diagnosis of bladder cancer requires only a urine sample. Tests for tumor markers help in therapy control.
Treatment methods
The treatment of a bladder tumor consists of surgery, radiation or chemotherapy. These methods are used in combination or individually. The age, health of the patient, extent and degree of malignancy of the tumor determine the therapy. Approximately 70 percent of all bladder tumors are detected at a stage when they are still growing superficially. They are then removed with an electric snare inserted through the urethra (transurethral resection).
Careful aftercare required
Since the frequency of recurrence is high, tumor-inhibiting substances are given at certain intervals after resection. In this local instillation treatment, the substance is injected into the bladder via a catheter. Regular cystoscopies to monitor therapy are still necessary.