Bladder cancer is the fourth most common malignancy worldwide, accounting for 4% of all cancers. In Europe and the US, 180,000 patients with bladder cancer are diagnosed yearly, and 60,000 die of the disease.
Bladder cancer is found more often among smokers and people who have worked in e.g. chemical industry, and the ratio of men to women with the disease is 3:1.
Fig. 1: Urinary bladder cancer with superficial cancer tumours
The first sign of bladder cancer is usually hematuria and tumour cells in the urine (positive cytology), but fortunately 70-80% of patients with diagnosis of bladder cancer have superficial (non-invasive) disease that is curable by local surgery and intravesical chemo- and immunotherapy.
Due to inadequate diagnosis, local surgery, chemo- and immunotherapy as much as 70% of patients recur after treatment making bladder cancer the most prevalent and costly type of cancer.
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Fig 2. Papillary tumour.
Courtesy of Prof. Zaak, Münich
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Fig. 3 Carcinoma in situ (CIS).
Courtesy of Prof. Zaak, Münich |
The aggressivness of some tumours like carcinoma in situ (CIS), makes the tumour difficult to control and 10-20% of patients with superficial disease will progress to invasive disease. In patients with invasive cancer, the tumour has invaded the bladder, and potentially into nearby organs. For patients with a tumour confined to the bladder muscle only, removal of the bladder (cystectomy) is the treatment of choice. When the tumour has spread to other organs there is need for systemic chemotherapy.