How Is Bladder Cancer Diagnosed?


Bladder Cancer Overview

The bladder, an expandable sac-like organ in the pelvic region, stores urine. Bladder cancer usually develops in cells that are located in the lining of the bladder. Although there are different types of bladder cancer, most of the cases diagnosed are of transitional cells (transitional cell carcinoma). The American Cancer Society reports that over 97 percent of bladder cancer diagnosed is of this type. An estimated 70,980 new cases of bladder cancer were diagnosed in the U.S. in 2009.

Some factors that can increase a person’s risk of this disease are smoking, exposure to certain toxic chemicals, repeated bladder infections and age. When detected in its early stages, bladder cancer is very treatable.


Signs and Symptoms

Blood in the urine may be a warning sign of bladder cancer. However, there are other health problems such as kidney stones that can present similar symptoms. Other symptoms are a frequent need to urinate, pain and burning during urination. Because many of the symptoms of bladder cancer may be similar to those of other medical conditions, it’s important to see a doctor.

When these signs are present, a doctor takes a complete medical history and performs a physical exam. During a physical examination, a doctor checks the rectum or vagina for signs of a bladder tumor. If a doctor suspects that a patient has bladder cancer, she can recommend certain tests. There are a variety of tests and procedures used to diagnose bladder cancer. These can include cystoscopy, biopsy, urine testing and imaging tests.


Bladder Cancer Diagnosed



Usually performed under anesthesia, cystoscopy is a procedure in which an instrument called a cystoscope is guided through the urethra and into the bladder. Cystoscopy is one of the main procedures doctors use to detect bladder cancer. With this fiber-optic instrument, a urologist can examine the bladder for signs of abnormal growths or suspicious cell formations. During cystoscopy, the doctor can perform other procedures such as bladder washing, biopsy and fluorescence cystoscopy.

A biopsy may be necessary to remove a tissue sample for microscopic examination. Biopsies can determine if malignant cancerous cells are present and the specific grade of cancer (see Resources). In some cases, a needle biopsy is recommended to take a tissue sample.


Urine Tests

Urine tests may also be performed to find bladder cancer. Urine cytology involves the examination of urine under a microscope to determine whether there are cancer cells present. However, urine cytology is not foolproof. Urine culture tests are also used to check whether there is a urine infection.

Because bladder cancer and urine infection can present similar symptoms, urine culture tests are useful in differentiating between these two conditions. Some tumor marker studies can also require the testing of urine samples. Some of these tests include the NPM22 test and the BTA stat test.


Imaging Tests

If bladder cancer is detected by cystoscopy and other tests mentioned above, doctors can order various imaging tests. These tests can check for signs of spreading cancer in nearby bladder tissue, lymph nodes or other body organs. Intravenous pyelogram and retrograde pyelograph are two procedures utilized to detect urinary tract tumors.

In both of these procedures, dyes are injected and X-rays are taken to find any tumors. Other imaging tests that may be useful to check or confirm the spreading of cancer to other areas of the body are chest X-ray, computed tomography (CT), ultrasound, bone scan and magnetic resonance imaging scan (MRI).

Although a CT scan can detect the size and shape of a tumor, an MRI scan may show that the cancer has spread outside the bladder. CT scans and MRI scans can give doctors information on the stages of the cancer and treatment options.


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