About this disease
What it is about
There are no clear causes for the development of bladder cancer. However, the most important risk factors include smoking, exposure to occupational toxins (aromatic amines), increased consumption of painkillers, radiation therapy or chronic inflammation - also triggered by parasites (billharziasis).
The superficial foci arising in the mucosa, the so-called urothelium, have not yet grown into the muscle layer of the bladder wall. They are called non-muscle invasive carcinomas. They subsequently develop into invasive carcinomas. Thus, there is a possibility of spread to the lymph nodes in the pelvis and abdomen, as well as distant offshoots, called metastases, which spread to other organs such as bones, liver and lungs. Rarer are so-called non-urothelial tumors such as squamous cell, adenocarcinomas or small cell carcinomas.
Symptoms and consequences
The main symptom is macro- or microhematuria, i.e. visible or invisible blood in the urine. It can be completely painless or associated with irritation symptoms such as painful or frequent urination or urge to urinate. If the ureters or the lymph nodes in the abdomen are affected, urine outflow obstruction may follow. If metastases are present, pain in the bones, shortness of breath, weight loss, or nausea with upper abdominal pain may occur.
What we do for you
Examination and diagnosis
If there are symptoms or a suspicious urine examination, an ultrasound examination of the kidneys, the urinary tract and the bladder is performed. A computed tomography (CT) scan of the abdomen, chest and bones can reveal other causes of congestion, such as kidney stones. In addition, the extension of the disease to the bladder or neighboring organs can be evaluated, and possible metastases can be located. A cystoscopy is used for local assessment and tissue sampling. If necessary, the placement of a passive urinary diversion, can replace the function of the patient's own bladder."
In the early stages, the tumor can usually be removed via the urethra (transurethral resection). The risk of recurrence is reduced by administering medication into the bladder (instillation). If the cancer has already spread deeper into the bladder wall, the bladder usually has to be surgically removed (cystectomy). In this case, a new urinary diversion is created during surgery using a bladder replacement procedure. Chemotherapy and radiotherapy can be used before, after or instead of surgery - in the case of metastases, immunotherapies are also suitable.