Urinary bladder tumours
Among all malignant tumours, urinary bladder carcinomas are associated with the highest costs in the German healthcare system. They are the fifth most common malignant tumours among men and the eight most common among women. In the Federal Republic of Germany, the incidence rate of urinary bladder cancer is 48/100,000 among men and 19/100,000 among women. According to recent extrapolations of the Robert Koch Institute in Berlin, the incidence rate in the Federal Republic in 2010 was about 85,000 cases among men and 26,000 cases among women. The average age of both male and female patients is comparatively high, namely in the eighth decade of life. Compared to 1980, the incidence rate in 2014 was significantly higher, amounting to 35% among men and 75% among women. Compared to other countries, Germany was ranking second behind Denmark as regards incidence rates in 2016, exceeding the rates in the U.S. and Asia (Source: Robert Koch Institute Berlin).
About 70-75% of all urinary bladder carcinomas are diagnosed at the superficial stage (referred to as pTa stage). They are characterised by a high tendency towards recurrence and a low tendency towards aggressive growth forms. About 20-25% of all primary diagnoses are made at the so-called invasive stage (referred to as T1-T4 tumour stage), of which about 20% have already spread to remote organs (e.g. liver, lungs, bones).
A typical symptom that may suggest the presence of a urinary bladder tumour is what is referred to as painless macrohaematuria. Painless macrohaematuria is defined as the presence of blood in the urine visible to the naked eye without accompanying difficulties urinating. The cause of painless macrohaematuria should always be clarified by means of cystoscopy (see Diagnosis).
The presence of blood in the urine which is not visible to the naked eye but can be detected by means of urine analysis (referred to as microhaematuria) can also be caused by a bladder tumour. However, microhaematuria may also be a symptom of numerous other diseases (among them kidney diseases and stones), which is why the diagnosis should always include an examination by a nephrologist.
Other symptoms that may be caused by a bladder tumour include irritative urinary symptoms (e.g. frequent urge to urinate with small amounts of urine, frequent urination at night) or, if the tumour is located near the ureteral orifice to the urinary bladder, flank pain as a result of urinary stasis. Advanced tumours already infiltrating the bladder muscles may additionally cause symptoms by infiltrating the surrounding organs (e.g. irregular stool) or remote organs (e.g. pain in the spinal column caused by bone metastases).