Diagnosing Bladder Cancer

If there is a reason to suspect you might have bladder cancer, the doctor will use one or more of the methods below to find out if the disease is really present. Tests that examine the urine and bladder are used to help find and diagnose bladder cancer. Your doctor should talk with you about which of the following methods is appropriate for your situation.

• Medical history and physical exam: First, your doctor will ask you about your medical history to check for risk factors and symptoms.
• Urine cytology: In this test, urine from the bladder is sent to the lab to see if cancer cells (or pre-cancer cells) are present.
• Urine culture: A sample of your urine is sent to the lab to see if you might have an infection. Infections can sometimes cause symptoms like those of bladder cancer.
• Cystoscopy: If your doctor suspects bladder cancer, you will be sent to a urologist, who may examine you with a test called cytoscopy. For this test, the doctor will look into your bladder with a tiny, lighted tube called a cystoscope. You will be given medicine to numb the area. If the doctor sees anything  abnormal, a biopsy will be needed under anesthesia.
• Biopsy: A sample of tissue is removed during cystoscopy and looked at under a microscope. The doctor can tell if cancer is present and what type of bladder cancer it is.
• Flow cytometry or image cytometry: These tests, done on a urine sample, bladder washings, or on a tissue sample, measure the amount of DNA in bladder cells. This information can be useful in finding bladder cancer that has come back (recurred) after treatment.
• Bladder tumor marker studies: These tests look for certain substances released by cancer cells into the urine. More research is needed before these tests are used routinely. These are best used for patients with a known bladder cancer.
• Imaging tests: A variety of tests such as IVP (intravenous pyelogram), CT scans, MRI scans, ultrasound, and bone scans may be done to give the doctor more information about the cancer and whether it has spread.
       

  

                      IVP showing bladder cancer filling defect (mass) on left side of bladder.