Our expertise in bladder cancer

Without warning, I suddenly had blood in my urine. Lots of blood and every time I urinated. I had no pain, but it was a shock. That was in May 2021.

I had my first appointment with my GP and was then referred to a urologist. The ultrasound was immediately followed by the diagnosis: several tumors.

I was called in three times for tumor removal in Liestal, where a transurethral resection of the bladder tumor was performed each time.

When the samples were taken, it was discovered that the tumor had already attacked the muscle tissue; as a result, further treatment options were discussed at an interdisciplinary tumor conference consisting of urologists, oncologists, radiotherapists and radiologists.

I had my first appointment with PD Dr. Jan Ebbing at the Department of Urology at the University Hospital Basel (USB) in August 2021, accompanied by my wife.

It was explained to us that, in addition to chemotherapy, a complete removal of the bladder was necessary as the tumor had already grown into the muscles of the bladder.

Dr. Ebbing also discussed the various forms of urinary diversion with us (urinary stoma versus neobladder). The necessary requirements, the options for urinary diversion and the associated surgical risks were discussed with us.

I opted for the neoplasia and it was decided that I would first undergo chemotherapy in order to be able to treat the tumor even better.

I was able to receive the chemotherapy in Liestal, a total of four cycles. After the first cycle I still felt quite well, but after the second cycle I was struggling with skin rashes and exhaustion. And I was constantly cold. The freezing has remained and I still go to bed very early at night.

The neobladder surgery was performed successfully and without complications here at the USB by PD Dr. Jan Ebbing and Dr. Abolfazl Hosseini in January 2022.

The indication for chemotherapy is always individualized and patient- and tumor-specific. Side effects of chemotherapy do occur and are discussed with the patient by the treating oncologists during the pre-treatment consultation (editor's note).

A diagnosis like this turns everything upside down at first; you are insecure and scared. But my family, my daughters, had more difficulty accepting the diagnosis.

However, the most valuable and important thing is the support at home. I was informed about existing external support services, but didn't want to make use of them; I'm coping well.

At the USB, all tumor patients are psycho-oncologically evaluated and, if desired, supported (editor's note).

The pain was severe, but I'm good with pain. I was able to endure it. Mentally, you feel insecure and I also felt somehow at the mercy of others.

Pain can occur after bladder removal surgery, but there is good pain management. The minimally invasive approach and the use of robot-assisted keyhole surgery in particular significantly reduce the trauma to the body, which is associated with faster patient recovery and fewer complications (editor's note).

Later, after the bladder catheter had been removed from the neobladder and the bladder filled with urine for the first time, I struggled with sleep deprivation; I had to set the alarm clock at night, first every two, then every three hours, so that there was no overloading with the new bladder. However, the accompanying pelvic floor therapy went well.

A neobladder has no sensitivity and no motor activity. The urine volume must first be trained. It is therefore normal for patients to have to empty the neobladder at night and set an alarm clock. About 30% of male patients with a neobladder remain incontinent at night (more than 1 insertion), whereas about 96-98% of male patients are dry during the day, without restrictions (editor's note).

Yes, it seemed like the best option for me right from the start.

Yes, I feel well looked after here at the USB.

I was able to return to work in May 2022. Everything works well during the day and I have no problems or complications. At night (when my head isn't thinking) I have to wear insoles. I no longer have to take any medication. With the exception of erection support.

I am called in for a check-up every six months and then once a year. So far, everything has been normal.

Communicating openly with family and friends. I felt the need to spare my loved ones and family, but open conversations were the best way to help everyone deal with the illness.

Even with work colleagues and acquaintances, there were those who avoided me and those who asked directly how I was doing. I was able to give a direct answer, and that was always really good and helped me to deal with the situation.

It all started with a sore hip in the fall of 2022, when I was in the USA on business. I came back to Switzerland and had to undergo hip surgery in December. Following the operation, blood was found in my urine, a typical symptom of bladder cancer.

The diagnosis after the CT confirmed the suspicion: a bladder tumor. I was then unable to return to the USA and regular work is still not possible. However, this is only partly due to the bladder tumor and the associated therapy. I am also struggling with the consequences of reactive arthritis in my knee and my operated hip.

I had surgery at St. Claraspital in January 2023. The first TUR-B (transurethral resection of bladder tissue) was followed by a resection.

BCG (Bacillus Calmette-Guérin) instillation was started in March. After the third instillation, my knee and calf swelled up. A side effect of the instillation that was not recognized as such. This was followed by an operation on my knee and a puncture in my hip. The treatment had to be discontinued.

At the end of May, three small tumors were discovered during a cystoscopy. Two tumors were superficial, one tumor turned out to be a carcinoma in situ (CIS) with a high risk of recurrence.

To date, the findings are: no more visible tumors.

This marathon of doctors and diagnoses is extremely stressful and tiring. My daughter accompanied me to the appointments a few times. Of course, you also try to gather information yourself through all available channels.

I also sought external psychological help from time to time. But only for a short time. Ultimately, you have to deal with the illness on your own. I also try not to burden my family too much with it.

I also had to learn that the emotional life during such treatment is not so easy to explain and that you shouldn't underestimate the psychological strain.

After the second TUR-B, I received a first instillation of epirubicin at St. Claraspital. This is the standard treatment.

In August 2023, a referral to the USB was discussed at the tumor board with Prof. Cyrill Rentsch. A docetaxel/gemcitabine combination therapy is offered here at the Urology Clinic, which is more promising. The therapy was then started immediately.

The procedure for the instillation cycle is as follows: for six weeks I received alternating doses of chemotherapy flushed into the bladder on two consecutive days.

On the first day a dose of Docetaxel, on the following day a dose of Gemcitabine. This was followed by a four-week break. Maintenance therapy was then started after a positive cystoscopy.

The first consultation is held after the consultation appointment for the last round of instillations. The patient appears athletic, open, composed, but also tired. This is one of the side effects that he struggles with in the first 3-5 days after instillation. Exhaustion and nightmares also bother him.

After my hospital stays and visits to doctors at St. Claraspital and Merian Iselin Spital, I had to readjust to the USB. The USB is a big place, so you can feel like one of many. But the priority is to get the right treatment. This is the case here.

I feel that I am in good hands with my attending physician, Prof. Cyrill Rentsch. My thanks also go to Heike Püschel, Study Nurse, who looks after me with great empathy during every examination. This is extremely valuable.

I am currently undergoing maintenance treatment. For 12 months, I come to the urology clinic every month on two consecutive days and receive a dose of Docetaxel on the first day and a dose of Gemcitabine on the second day.

For me, it's important to feel my body and keep moving. In my case, swimming and running training sessions helped me a lot to forget about the tumor, at least temporarily.

That's what I would say to someone living with a similar diagnosis - don't let up, fight. And believe in yourself.

The main risk factor for bladder cancer is smoking. Stopping smoking can have a positive effect on the relapse and progression of bladder cancer. Read more about our stop smoking consultation at the USB.

Signs include pain when urinating and frequent urination. However, the main symptom is visible or non-visible, painless blood loss in the urine. Patients with these symptoms should definitely be seen by a urologist.

Besteht der Verdacht auf Blasenkrebs werden wir eine Blasenspiegelung durchführen. Heutzutage kann dieser Eingriff durch den Einsatz einer flexiblen Kamera ambulant und ohne Narkose schmerzfrei in der Sprechstunde durchgeführt werden. Eine Blasenspiegelung dauert lediglich wenige Minuten. Zusätzlich werden wir eine Blasenspülung durchführen und so untersuchen, ob bösartige Blasenschleimhautzellen gefunden werden können. Zeigen sich in diesen Untersuchungen Auffälligkeiten, wird kurzstationär eine Gewebeprobe aus der Blase, minimalinvasiv ohne Hautschnitt, durch die Harnröhre hindurch entnommen.  

If a bladder tumor is found in the cystoscopy, it is removed through the urethra under anaesthetic. When first diagnosed, most bladder tumors are limited to the mucous membrane (70%) and the bladder can be preserved.

Urinary bladder tumors limited to the mucous membrane have a high risk of recurrence. To reduce this risk, after removal of the tumors, medication is injected into the bladder via the urethra at regular intervals using a catheter to reduce the risk of recurrence. Read more about our instillation therapy.

If the cancer has already grown into the muscles of the bladder when it is first diagnosed, the bladder must be surgically removed or treated with radiotherapy and chemotherapy.

Read more about robot-assisted cystectomy, radiotherapy and chemotherapy.

Rarely, however, bladder cancer has already spread throughout the body. In this case, cure by surgery and radiotherapy is no longer likely. However, there are good therapies that can greatly prevent further progression of the disease.

The earlier bladder cancer is detected, the higher the chances of recovery. If the tumor has not yet grown into the muscle layer of the bladder, the chances of recovery are around 80%.

Unfortunately, non-muscle-invasive bladder cancer often returns even after complete removal.

We offer our patients individual tumor follow-up care to detect bladder tumor recurrences at an early stage and treat them accordingly.

Our clinic also has extensive experience in advanced bladder tumor therapy.

Urology registration office
Availability: Mon-Fri, 08.00 - 16.00 hrs

Phone +41 61 265 72 80
anmeldung.urologie@usb.ch

Contact for emergencies
During operating hours, please contact the Urology Registration Office. For urological emergencies outside of operating hours, the Emergency Center at the USB is there for you around the clock:
Emergency Center University Hospital Basel
Petersgraben 2
4031 Basel
Phone +41 61 265 25 25

Contact for queries about your operation
Surgery Coordination Urology
Phone +41 61 328 58 15
op.urologie@usb.ch

Contact for consultation appointments at Felix Platter Hospital
Registration office Urology UAFP

Urology consultation hours on Mon and Fri, all day from 8.00-16.30 and Tuesday afternoon from 13.00-16.30

Phone +41 61 326 42 10
urologie.uafp@usb.ch

Contact applications

chefarztsekretariat.urologie@usb.ch

Phone +41 61 328 72 84