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How do you diagnose it?
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A doctor will typically undergo a number of diagnostic tests before a definitive diagnosis of cancer can be made. John Muir Health offers the full spectrum of advanced technology used in diagnosing and staging bladder cancer.
Cytology - the microscopic evaluation of cells found in urine - is usually the first test conducted when bladder cancer is suspected.
Your physician may also perform an in-office procedure known as cystoscopy, in which the interior of the bladder is inspected through a slender lighted tube (the cystoscope), which is inserted into the bladder through the urethra. At John Muir Health, patients benefit from the use of flexible cystoscopes, rather than traditional rigid ones.
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If cancer is suspected, a biopsy may be performed. During the biopsy, which is usually conducted as an outpatient surgical procedure under general anesthesia, tissue samples from the bladder are removed through the cystoscope. The definitive diagnosis of bladder cancer is made by microscopic evaluation of these tissue samples by our board-certified pathologists.
Other useful diagnostic tests that may be performed to assess the presence and/or the extent of bladder cancer include:
Intravenous pyelography - a specialized x-ray procedure, in which contrast dye is injected into a vein enabling the physician to assess all the structures of the urinary tract (kidneys, ureters, bladder, and urethra).
Ultrasound scan - a non-invasive test that uses sound waves to create images of structural abnormalities within the bladder and nearby organs.
CT (Computed Tomography) scan - a computer-enhanced x-ray procedure that provides a high level of structural detail by recording cross-sectional images from many different angles. CT can help determine if bladder cancer has metastasized, or spread, to other sites.
Magnetic resonance imaging (MRI) - sometimes used to determine if there has been any metastasis to lymph nodes or other organs. MRI uses a powerful magnetic field to create highly detailed images.
Once a definitive diagnosis of bladder cancer has been reached, your physician will need to "stage" your cancer - or determine how far the tumor has spread - to devise the best treatment plan. Staging is based on information gathered from the diagnostic tests described above, or any other tests that may have been ordered, including routine laboratory tests.
Bladder cancer staging is based on the TNM classification system, which assesses the extent of the primary tumor, lymph node involvement, and any distant metastases. Classification ranges from Stage 0 (early-stage cancer) to Stage IV (metastatic cancer). A detailed discussion of the various stages of bladder cancer and the appropriate treatment options for each can be found at: www.cancer.gov/cancerinfo/pdq/treatment/bladder/patient/
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