After prostate cancer, the second commonest urological form of cancer is bladder cancer. Each year, around 25,000 people throughout Germany fall ill with this and a good half of them die as a result of the tumor. The earlier the cancer is detected, the better are the chances of healing. Unfortunately, the public perception is that bladder cancer plays a subordinate role, which means that too little attention is paid to the possible symptoms. Bladder cancer also has a high rate of recurrence. The interdisciplinary collaboration between several medical fields guarantees good diagnosis, treatment and aftercare.

Overview

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Bladder Cancer - Further information

Contacts for bladder cancer conditions

It is generally the patient's own doctor who first suspects bladder cancer and then refers the patient to the urologist. Depending on the individual findings, further treatment continues in a suitable uro-oncology therapy center or an urological out-patients clinic. In searching for the right center, the health insurance schemes may give further help.

What are the special features of bladder cancer specialists?

Bladder cancer specialists are trained human medicine practitioners and have specialist medical training in urology and urological oncology Additionally, they have training focusing on certain fields, i.e. in kidney, bladder and prostate tumor surgery and in metastasis surgery. They are thoroughly familiar with the latest surgical methods. An important part of the remit to fulfill is giving patients objective information on the disease, the prognosis and the options for influencing the treatment themselves. The doctors work in urology in university hospitals or clinics. Many have published papers on their field of expertise.

Bladder cancer centers: specialist departments in urological clinics

The specialists in bladder cancer centers deliver both diagnoses and treatment. They deal with tumor conditions of the bladder, ureter, urethra and the renal pelvis and select suitable treatment options. Up to now, there are no specialist clinics for bladder cancer in Germany, though there are specialist clinics for urology and pediatric urology. Also, many oncological centers are qualified for urology. Several different disciplines work together here, which ensures that there are very good interactions between the different fields.

Main activities of bladder cancer centers

  • function-conserving cystectomy (removal of the bladder in men and women)
  • ileal neobladder (a substitute bladder created from the small intestine)
  • Mainz pouch (surgical technique for urine draining)
  • catheterizable stomata (artificial exit to the abdominal wall)
  • endo-urology (minimally-invasive urological surgical procedure)

Features of urothelial cancer

Urothelial cancer is also known as transitional cell cancer. It occurs in the transitional tissue of the urinary drainage tracts. It develops from the membrane of the organs, from the cells of the urothelium. As a consequence, urothelial cancer can also affect the bladder, renal pelvis, urinary ducts and urethra. Urothelial cancer of the bladder is significantly more common than in the renal pelvis or urinary ducts. This is why the term for this - bladder cancer - has also become common currency. Men contract this condition three times more often than women. As age increases, the risk of them contracting this condition increases as well.

The urothelium is located in

  • the renal pelvis
  • the urethra
  • the ureters
  • the bladder

When should those affected consult a specialist?

Pain free bleeding from the urinary tract is always cause for suspicion so the person concerned should consult an urologist. Anyone suffering from fatigue, reduced urine flow, diffuse pains in the kidney area and frequent urinary urgency should consult a doctor. Computed tomography and tissue samples can be used as diagnostic tools. People with chronic inflammations of the bladder membrane have an increased risk, also smokers and patients needing to take particular medications.

Diagnosis of bladder cancer

Use of a urine culture can establish whether or not there is an infection of the bladder. It is also possible to find evidence of tumor cells in urine. As an early detection method, the urine marker tests are less suitable however because they are not unambiguous. For reliable identification a bladder examination is needed. During the examination, tissue is taken at the same time. It supplies indications of the type of cancer and how far the tumor has already penetrated into the bladder wall.

Treatment of a bladder tumor

The treatment applied depends on the stage of the tumor. If it is superficial cancer, the urologist can remove the tumor during the tumor examination using a scraper. These patients have a very good prognosis. Because bladder tumors frequently recur, local medication is applied as a preventive measure. A usual measure is radiation of the tissue affected (uroradiology). If the tumor has already grown into the bladder wall, the bladder may well have to be removed and replaced. Even in the case of advanced bladder cancer, the therapeutic options have improved significantly in recent times. In certain patient groups, urologists also achieve successful results with combined immunotherapy.

Conclusion

Particularly with bladder cancer and urinary tract tumors, it is important to take note of the early signs because no pain is felt in the initial phase. The first points of contact are the patient's own doctor and an urologist. They set in motion the first treatment steps and refer the patient to a hospital qualified for this.