HEALTH INSIGHTS

Bladder Cancer: Diagnosis

October 25, 2018

Bladder Cancer: Diagnosis

How is bladder cancer diagnosed?

If your healthcare provider thinks you might have bladder cancer, you’ll need certain exams and tests to be sure. Diagnosing bladder cancer starts with your healthcare provider asking you questions. He or she will ask you about your health history, symptoms, risk factors, and family history of disease. Your healthcare provider will also do a physical exam that may include a rectal or vaginal exam. This is done to check for tumors that are large enough to be felt.

What tests might I need?

You may have one or more of these tests:

  • Urinalysis and urine culture

  • Urine cytology test

  • Urine tests for bladder cancer tumor markers

  • Cystoscopy

  • Intravenous pyelogram (IVP)

  • Bladder biopsy

Urine tests done in the lab

Urinalysis and urine culture

The goal of this test is to look for signs of infection or other problems that may be causing your symptoms. You will urinate in a cup for this test. Then your urine is sent to a lab to be tested for blood, certain chemical levels, and signs of infection. The urine is also cultured to see if organisms, such as bacteria, grow. It normally takes a few days for the test results to come back.

Urine cytology test

For this lab test, your urine is checked under a microscope. The cells are checked to see if any of them look like cancer or pre-cancer cells.

Urine tests for bladder tumor markers

These tests are used to look for markers or substances that bladder cancer cells make and release into your urine.

Imaging tests

Cystoscopy

This procedure lets your healthcare provider look at the inside of your bladder. It’s the best test for diagnosing bladder cancer. Your healthcare provider slides a very thin, flexible tube through your urethra into your bladder. The tube has a tiny camera and light in it(cystoscope.) Salt water is put into your bladder through this same tube. This fills your bladder and helps your healthcare provider see the inside wall of your bladder. If a change is seen that looks like it might be cancer, the provider may take out a tiny piece of for testing. Your healthcare provider may also take a urine sample with a bladder wash during a cystoscopy. This is when the salt water is removed, saved, and checked at under a microscope.

Intravenous pyelogram (IVP)

In this test, a contrast dye is put into a vein in your arm or hand. As the dye moves through and outlines your kidney, ureters, and bladder, your healthcare provider takes a series of X-rays. This test is used to find tumors, other changes, kidney stones, or any blockages. It’s also used to measure blood flow through your kidneys. This test can help to rule out other diseases or check for cancer in other parts of the urinary tract.

Bladder biopsy

A biopsy is a small piece (called a sample) of cells and tissue. A bladder biopsy is usually done during cystoscopy. If your healthcare provider sees something that looks like cancer while doing the cystoscopy, he or she will remove a small sample of that tissue.

Any removed tissue is sent to a special doctor called a pathologist. This doctor looks at the tissue under a microscope for signs of cancer.

If there is cancer, the biopsy can help tell whether the cancer is just on the surface of the bladder or if it’s gone into the deeper layers of the bladder wall.

It normally takes several days for biopsy results to come back. A biopsy is the only sure way to know if you have cancer and what kind of cancer it is.

Getting your test results

When the results of your biopsy are back, your healthcare provider will contact you. Your provider will talk with you about other tests you may need if bladder cancer is found. Make sure you understand the results and what follow-up you need.

Updated:  

October 25, 2018

Reviewed By:  

Richard LoCicero MD,Kim Stump-Sutliff RN MSN AOCNS,Lu Cunningham