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Bladder cancer

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Symptoms Who is at risk Diagnosis and examination Treatment Schedule your appointment with us

Symptoms

Bladder tumors can be either benign or malignant. Most malignant tumors develop from the epithelium lining the bladder wall (urothelium).

The most common symptom of bladder cancer is blood in the urine. It occurs in approximately three quarters of all patients. Blood is usually present throughout the entire urine stream, not only at the beginning or end of urination. As with other types of urological cancers, blood in the urine may not always be visible to the naked eye in the early stages and can only be detected through laboratory testing.

Other possible symptoms include difficulties with urination. These may include painful urination, frequent urination, or a sudden and urgent need to urinate. These symptoms often indicate that the disease has progressed to a more advanced stage.

If a tumor blocks the opening of the ureter into the bladder, urine may start to build up in the urinary tract above the bladder. In such cases, the disease may cause pain in the lower back area. However, this type of symptom is uncommon in bladder cancer.

Who is at risk

Bladder cancer accounts for approximately 7% of all malignant tumors in men and 3% in women. It is the second most common urological cancer. It affects men approximately three times more often than women, and its incidence continues to increase. The average age at diagnosis is 65.

A number of carcinogenic substances contribute to the development of bladder cancer. Besides smoking, which is responsible for approximately 50% of bladder cancer cases in men and 30% in women, other risk factors include exposure to certain industrial products and intermediates, especially aromatic amines used in rubber processing and the chemical industry.

A specific risk group includes people with chronic bladder infections and those with urinary stones.

Diagnosis and examination

To diagnose bladder cancer and determine the extent of the disease, we use several diagnostic methods. A urine sample is examined in the laboratory using urine cytology. The main examination used in the diagnosis of bladder tumors is urethrocystoscopy, an endoscopic examination of the lower urinary tract that also allows a tissue sample to be taken for histological analysis if necessary.

Other examinations that can support the diagnosis include pelvic CT, abdominal ultrasound, and intravenous urography. This is an X-ray examination performed after administering a contrast agent, which allows the doctor to assess the condition of the urinary tract. Additional tests used to determine the extent of the disease and plan treatment may include a chest X-ray and skeletal scintigraphy, a radionuclide examination of the bones.

Treatment

At the time of diagnosis, approximately 85% of patients have localized disease, while 15% already have lymph node involvement or distant metastases.

 

The main treatment for patients without metastases is surgery. Superficial tumors are usually treated by removing suspicious areas from the bladder wall using transurethral resection (TURBT). This procedure may be followed by immunotherapy or chemotherapy.

For invasive tumors, complete removal of the affected bladder is usually necessary. This procedure is called radical cystectomy. In men, the prostate and seminal vesicles are removed together with the bladder. In women, the uterus, adjacent organs, and the front wall of the vagina may also need to be removed.

 

The main treatment for patients with metastatic bladder cancer is palliative systemic chemotherapy.

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