Bladder cancer

Atlas der Gesellschaft der epidemiologischen Krebsregister - Quelle: GEKID
Atlas der Gesellschaft der epidemiologischen Krebsregister - Quelle: GEKID

Incidence rate bladder cancer 2004 - Picture: Detlef Höwing According to estimates by the Robert Koch Institute in Germany diseased in 2004 about 28,750 new cases of bladder cancer and 6,194 people died from this cancer. That is about 4,000 sufferers more than the millennium. In order for the cancers of the bladder (transitional cell carcinoma) is the second most common after prostate cancer urological cancer in men and women is still in front of the cervical cancer. One third of new cases of cancer at initial diagnosis already occurred in an invasive growth stage and therefore difficult or impossible to treat. Despite these alarming figures is known to the public little about this type of cancer.

The cancer risks

Bladder cancer is a cancer that often occurs with such people who had often to do during their lifetime with cancer-causing substances. Here, the time may lag decades until the outbreak of the disease. Unfortunately, still too few people know about the risks communication, which can lead to bladder cancer.

The most important risk factor for bladder cancer is the long-standing smoking. Have an increased risk of bladder cancer due to the frequent handling of carcinogenic substances also:

  • Industrial and construction workers,
  • Employees who come into contact with tar products,
  • Professional drivers and gas station staff,
  • Firefighters,
  • Print shop employees,
  • Painters, coatings,
  • Employees of the plastic locking or processing,
  • Hairdressers.

Another risk factor is almost only women to wear: hair coloring. Anyone who has about 15 years regularly dyed her hair with permanent means, in which the bladder cancer risk tripled. And who goes swimming in African waters, the butted bilharzia (schistosomiasis also), a bacterial infection, and bladder cancer. Also, a family history leads to an increased bladder cancer risk.

Bladder of woman and man - Picture: Detlef Höwing

Bladder of woman and man – Picture: Detlef Höwing

Men are about three times as likely to be affected by the published estimate of the Robert Koch Institute (RKI) than women with smoking women are more at risk than men. But an early diagnosis even obtained risk groups rarely, because they are available at the public health insurance companies do not even.Because already in the 60s of last century, urine tests were taken off the list early.Fatal as it now shows at the ever-increasing incidence figures. Here a risk-adapted screening of affected populations would help.

After all, a third of those affected already suffering from an invasive tumor, when the diagnosis is made. This affects the healing and survival rates significantly. Experts like the urologist Professor Arnulf Stenzl of the University Hospital Tübingen calling for some time to examine people with an increased risk of bladder cancer routinely back.

And: „We can improve the diagnosis of bladder cancer only by a struktuelle reorientation. A risk-adapted screening is in cancer prevention certainly one of the most important points in order to obtain cost-benefit efficiency. This would have a prevention potency of 3,000 to 5,000 people per year, which are not diagnosed at diagnosis with invasive bladder cancer, „said Dr. med. Liidecke Gerson, Urologist.

Dr. Lüdecke has developed a Risk Check for the Internet, with each free at: his personal risk of developing bladder cancer, can identify. He also advises all women to take blood in the urine, very seriously. They are the most important symptom of a carcinoma of the bladder. Moreover, pain during urination, and frequent urination may indicate a tumor. These symptoms are also typical of the frequently occurring in women cystitis. There is therefore a danger that even doctors assess the symptoms initially wrong and thus precious time goes by, to the treatment of cancer begins.

Possibilities of early detection

For a favorable prognosis, it is crucial that the bladder cancer is detected in time. But early symptoms there are not in this disease. The tumor can grow unnoticed for years. „Symptoms when bladder cancer only when the tumor breaks down and it bleeds, or if the tumor is caught in the bubble output,“ commented Prof. Dr. med. Jens Erik Altwein.

„Early detection of high risk patients may reduce the number of deaths caused by bladder cancer.Bladder cancer can already ten, 20 or even 30 years unnoticed grow in the bladder and then suddenly report at an advanced stage with complaints. A specific early detection of risk patients when doctor is crucial for successful treatment and survival of patients. Because with timely treatment, the chances of recovery are good, „says Dr. Lüdecke.

Women as well as men who have a risk of developing bladder cancer should therefore be tested regularly with their physician in the course of cancer screening on the presence of bladder cancer.

Here it is not enough to examine only by urine test strips for blood in the urine out. Because blood in the urine can have various causes. When blood in the urine further urologic evaluation is here absolutely necessary to find out the causes.

If the doctor has found in the urine test blood in the urine or increased levels of UBC Rapid test, this does not mean long yet that bladder cancer is present. The causes may be other. But now the urologic evaluation of the causes is essential.

The urologist will then again cause extensive urine tests, in which inflammatory markers, blood in the urine, a microscopic examination of dead cell material (cytology) and on request once the UBC Rapid test to be determined.

In addition, an ultrasound of the abdomen should be made (ultrasound examination of the abdominal cavity), in which a major focus on the Harnableitungssystem (kidney, ureter, bladder) will be placed. Tumors in the bladder are namely often visible already in the sonography.

The gold standard for the diagnosis of bladder cancer, the cystoscopy (cystoscopy) has prevailed, which always takes place when a suspected bladder cancer is present. The urologist is either a rigid (often used in women) or a flexible endoscope (in men), which is inserted through the urethra to examine my bladder as to whether here present pathological changes, which the further investigation by ablation and pathological examination suspicious areas require. During this investigation pathological changes in the urethra can be detected.


  • Not every person has the risk of developing bladder cancer.
  • Everyone should therefore know its risk, the med with the RisikoChek Dr. Gerson Liidecke can be determined (
  • Already at a medium risk urgently regular screening tests from the age of 40 are recommended to bladder cancer back.
  • In urine in the blood, increased UBC Rapid Test or positive UBC Rapid Test, painful urination or other symptoms of the urinary system further urologic evaluation is absolutely necessary.
  • No testing or examination solely, a bladder cancer safely diagnose. Only the most diverse research methods merge to assured results.
  • Bladder cancer is detected early easily cured.

Author: Detlef Höwing

Prof. Dr. med. Manfred Beer, Chief of Urology of the Franziskus-Krankenhaus Berlin,
Dr. med. Jörg Neymeyer, OA Urogynecology the Franziskus-Krankenhaus Berlin,
Dr. med. Gerson Liidecke, Consultant Urologist, Giessen,
Dr. med. Frank King, FEBU, Berlin,
PD Dr. med. Frank Christoph, FEBU, OA of the Department of Urology at the Charité Berlin,

The neobladder


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