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Bladder Cancer Diagnosis

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A urologist is the most common type of specialist to help identify the cause of your symptoms. The doctor will assess your personal and family medical history to learn more about your symptoms and possible risk factors for bladder cancer. They will also run tests to gather information.

Tests Used to Diagnose Bladder Cancer 

Blood and urine tests will be run to look for signs of cancer or other conditions.

The urologist may also look inside your bladder with a cystoscope. This is a lighted instrument that allows the doctor to check for any growths or other conditions that could be causing symptoms. A blue light cystoscopy may be used if they specifically suspect cancer. With this process, a light-activated drug is put into the bladder which is taken up by cancer cells, if present. When the urologist shines a blue light through the cystoscope, any cancer cells containing the drug will glow (fluoresce), making it possible to see more than  with regular white light.

If during the cystoscopy the urologist notes areas that look abnormal, it’s likely that a biopsy will be performed. It can be done right away or scheduled in the near future. The biopsy for the bladder is called a transurethral resection of bladder tumor (TURBT). The urologist will remove the area that looks abnormal along with some of the bladder muscle to be tested for cancer. 

CTA

Additional Tests After a Bladder Cancer Diagnosis

If the biopsy results show that cancer is present, the report will include the specific type of bladder cancer and other important information for the oncologist when making a treatment plan. Additional tests will be needed to determine the extent of cancer. These can include:

  • Intravenous pyelogram (IVP): A series of x-rays of the kidneys, ureters, and bladder to find out if cancer is present in these organs. A contrast dye is injected into a vein. As the contrast dye moves through the kidneys, ureters, and bladder, x-rays are taken to see if there are any blockages.
  • CT scan: A procedure that takes pictures of the inside of the body using x-rays taken from different angles. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. 
  • PET/CT scan: This is used more often when the bladder cancer is muscle invasive to see if cancer has developed in other areas of the body including the lymph nodes.
  • MRI: This can be used to see if the cancer has spread to the lymph nodes or soft tissue outside of the bladder.
  • Ultrasound: Sometimes used to look at the size of the bladder, the shape of the tumor and to look at the kidneys for signs of cancer.
  • Chest x-ray: If there is reason to believe the cancer has spread outside of the bladder, your chest area will be x-rayed to see if the cancer has spread there.
  • Bone scan: To determine if cancer has grown into the bones.

The information provided by these tests along with the TURBT results allows the oncology team to determine the stage of bladder cancer and the best treatment plan for you.