How Will My Doctor Determine if I Have Bladder Cancer?

“For anyone with blood in the urine, we have to do tests to determine what the source of that bleeding might be. That source of bleeding could be anywhere in the urinary tract,” adds Dr. Shah. “We look either at the upper urinary tract, the kidneys, and ureters, or the lower urinary tract.”

Bladder Cancer Tests

You may need to have several tests to determine if you have bladder cancer. Tests may include:

• Physical exam: Your doctor will check for any signs of disease in your body. They will ask for a detailed medical history, including any past or current conditions, medications, and family history of cancer.
• Urine sample: The doctor may take a sample of your urine to look for blood or cancer cells. He or she may also send a urine sample to the lab for a urinalysis and/or urine culture to check for infection.
• Cystoscopy: During this procedure, your urologist will use a numbing medication in the urethra. A thin, lighted tube is inserted into the opening of your urethra and slowly fed up through your urethra, bladder, and into the bladder lining. Using a special lens, your doctor will examine the area for any abnormalities or signs of disease. This is a short outpatient procedure that’s usually done in the urologist’s office.
• Tissue biopsy: Your doctor may take a sample of tissue from the bladder and/or surrounding areas during a cystoscopy. A pathologist will analyze the tissue samples to see if cancer cells are present. This is not always necessary, but it may help your doctor determine the next steps in diagnosis or treatment.

Imaging Studies

Imaging tests use x-rays, magnetic fields, sound waves, or radioactive materials to take pictures of the inside of your body.

• Ultrasound: An ultrasound uses sound waves to create images of your kidneys, ureters, bladder, and other organs. This is usually the first imaging test done for someone who is experiencing blood in their urine.
• CT urogram: A CT urogram shows detailed images of the bladder and urinary tract. A dye is given through an intravenous (IV) line or directly into your bladder, allows the lining of the bladder to show up more clearly on the scan.
• Intravenous pyelogram (IVP): An intravenous pyelogram (IVP) is a series of x-rays taken after a dye is injected into your veins. The dye highlights the kidneys, ureters, and bladder to help show problems with those organs.
• Retrograde pyelogram: A thin catheter tube is inserted into the urethra and slowly fed up into the ureter. X-rays are taken while a contrast dye is injected through the catheter. This test can help show how well your kidneys and ureters are working and if there are any blockages.

When Testing Reveals a Bladder Cancer Diagnosis

According to Dr. Shah, two common scenarios bring patients into his office. “In one scenario, the patient has been told that they might have a tumor in their bladder, either because they saw blood in the urine or because someone did a CT scan or an ultrasound that shows what looks like a mass in the bladder.”

“The other scenario, which we see fairly often, is that the patient has been diagnosed with bladder cancer by their local urologist,” explains Dr. Shah. These patients often prefer to receive their cancer care at a treatment center, where they benefit from a multidisciplinary treatment approach.

If you’ve been diagnosed with bladder cancer, your healthcare provider may recommend additional tests to determine the stage and grade of your cancer.

Your urologist will refer you to a cancer treatment center where you can receive a multidisciplinary approach to diagnosis and treatment.

Staging Bladder Cancer

Bladder cancer staging looks at how far bladder cancer has spread within your body. Staging also helps healthcare providers choose the best treatment options for you, based on your specific cancer type, stage, grade, and other factors.

Bladder cancer that hasn’t spread beyond the lining of the bladder is considered low-stage or non-invasive.

Bladder cancer that has spread to other areas of the bladder or other organs is considered high-stage or invasive.

Bladder Cancer Grade

Bladder cancer is further broken down into two grades based on how the cells look under the microscope.

• Low-grade bladder cancer: This cancer looks less aggressive under a microscope.
• High-grade bladder cancer: This cancer looks more aggressive under a microscope.

Accurate grading and staging of bladder cancer are crucial in determining the most effective treatment and management plan.

Concerned about your symptoms?

Your doctor is your best resource for finding out what’s causing you discomfort. Some symptoms are more serious than others. Don’t ignore anything that doesn’t feel quite right.

If you have any type of blood in the urine or are experiencing other symptoms, it’s important to call your healthcare provider right away.

 

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