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A Tumor in the bladder is often only spät noticeable. Für some people examinations are, therefore, useful

Bladder cancer is only spät noticeable. Experts hold checkups therefore für useful

"A pack a day I smoke." Vöcompletely at ease erzämiss him some bladder cancer patients from their cigarette addiction. "Unfortunately, the connection is too little bekannt", Dr. Gerson L&uuml says;ceiling, a urologist at the University hospital of Gießen. Many wüauthorities think, at best, of lung cancer.

However, the gr&ouml is Smoking;ßte risk factor für bladder tumours, around the Hähalf goes zur&uuml it;ck. Almost 30,000 people in Germany are diagnosed after Schärequirements of the Robert Koch-Institute jäa year new. Are mainly affected Mämen.

Screening

Many spüren long unaware of their disease. Typical für bladder cancer are blood in the urine, stäa constant urge to urinate, hästage urination and abdominal pain. "But often the power for a long time not bemerkbar", so Lüceiling. A Früh­detection program, such as in the case of colorectal cancer.

Precautionary investigations müshot patients self-pay. Für people with erhöhtem risk was such a Maßtaking once-a-year makes sense, so Lüceiling. Because the früa so-called Urothelial carcinoma is discovered, the better lässt to treat it.

The persöpersonal risk prüfen lässt, for example, with the Lüceiling developed a free Online Test on www.risikocheck-blasenkrebs.info. Depending on the number of points going to the urologist can &ndash be advisable; even if no symptoms are present.

Camera in the Harnröhre

The specialist examines the urine, a cystoscopy n&ouml is;tig. Just so läkl&auml sst clearly;ren, whether or not a Tumor is present. Under öits literal Betäexercise is a dünnes, flexible endoscope through the Harnröhre in the bladder eingeführt. It is a small camera is located. So the doctor Gewebever&auml can;changes to recognize.

About two-thirds of the tumors grow in the upper mucosal layers of the bladder the skin and not penetrate in the depth. They are usually less aggressive. "Then it can be treated so that the bladder will get bleibt", Professor Christian Bolenz, head of urology at the Universit&auml says;tsklinikum Ulm.

The doctor must ­only the verämodified tissue ablation. The surgery and anaesthesia lasts about 20 minutes, patients köcan leave the clinic after a few days.

The Rückfall-risk wegspülen

However, it is häoften to Rückfäcases. "Depending on the Aggressivität of the tumor is the risk dafür in the two years after the procedure in 30 to 70 Prozent", L&uuml says;ceiling. The aftercare is therefore particularly important.

More Mämen affected

The number of bladder cancer patients is easy to rückläfrequently. Mämen develop three times as häfrequently as women. Für the vierth&auml it;most common type of cancer after prostate, bowel and lung cancer.

Regelmäßige Blasenspülungs, outpatient, made by a urologist, köthe probability f&uuml can;r a Rückfall reduce. Gespült is either with a chemotherapeutic agent or with abgeschwäkilled tuberculosis bacteria.

"This lösen in the bladder a Entzümaking out, activate the immune system and act against precursors of Krebszellen", erläexplained Bolenz. Unfortunately, it comes occasionally to stämore powerful complaints, äsimilar to a Blasenentzü- making or a flu.

Particularly important is the Sp&uuml seems;conversion to be immediately after the intervention, as a recent study in the journal JAMA suggests. The authors compared the effect of a Spüwith the chemotherapeutic agent gemcitabine with a Placebo-Spü.

Aftercare against Rückfall

In the gemcitabine group, 67 out of 201 patients suffered within four years of a Rückfall, in the control group, there were 91 of 205 patients. Aftercare gehören also regelmäßige reflections Bubbles.

"It is important to möas früh intervention to köcan, if the Tumor re-auftritt", Bolenz says. The inquiry was today, with modern instruments is significantly less unpleasant than frü. And möperhaps there will soon be an Alternative. Bolenz: "It is one of the verläsuch a horrible urine test for the detection of bladder cancer worked."

How high is the risk?

Risk Smoking

30 to 70 percent of the so-called Urothelial carcinomas are characterized begüsupports. The more someone smokes, the höforth the risk. The cancer-causing substances from cigarette smoke can reach the urine in the bladder.

Persöpersonal risk

Gender and age also play a role. Mämen makes it three times as häoften as ­Women. You are diagnosed, on average, 73 years of age, women with 76. Some people are missing außerdem a specific enzyme. "You köcan toxins contribute to the development of bladder cancer, bad abbauen", erklärt urologist Gerson Lüceiling.

Risk Professional

Certain chemical substances, which are absorbed by breathing and through the skin, föpromote bladder cancer. Especially gefädangerous the group of aromatic amines. They are used in the manufacture of paints and chemicals that are contained in tar and pitch. Gefährdet are about workers in the chemical, steel and leather industries, painters, auto mechanic, aluminum smelter, and a dental technician.

"It köcan decades go by, until the consequences show. We will treat today’s patients between 1955 and 1980 in a high-risk industry worked haben", L&uuml says;ceiling. A appropriate cancer is suspected, the doctor, the professional must notify the cooperative. When someone at least two years under risk tätig was, he is entitled to Entschäending. A supplementary pension may also später still surviving.

Medical Risk

Anyone who has already received due to another tumour radiotherapy in the small pelvis, or chemotherapy with cyclophosphamide, has a erhöreported an increased risk für cancer of the bladder. Stäamplifier gefäare hrdet, people with chronic urinary tract infections, and duration-Katheterträeng. Außerdem erhöamong other things, taking the pain by means of Phenazetin (in Germany, no longer in the trade) and the tropical infectious disease schistosomiasis increase the risk.

In patients whose Tumor has already grown into the bladder muscle needs to be removed the Organ. Üusually a surgery with gro&szlig is;em an abdominal incision. Increasingly but it also operates in a minimally invasive manner with the assistance of robots.

Robotic surgery bewährt

Long, in Germany there were reservations –in the United States &Auml use;the procedure doctors a long time ago. Now bestäestablished one of the first großen studies in the journal Lancet, even a slight advantage of the robot variant. Patients lost less blood and were able to leave the hospital sooner, but there were fewer complications and virtually no Üsurvival advantage.

Many of these patients have moved, particularly the question of how you can live without a bladder. This Problem is in the same intervention gelöst. The surgeon creates an artificial bubble of a Stück Dünndarm or – häufigstes approach – a küartificial urine output.

The urine then collects in a bag that is worn on the abdomen. This fäthe llt under the clothes on, makes no Geränoises and smells. Expert Bolenz: "You can be fully active, even going for a swim."

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At cystoscopy, the physician examines the urinary system using a special Untersuchungsgerät. when the diagnostic method is useful and how the investigation abläuft