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Diagnosis and Prognosis of Bladder Cancer

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Your doctor will ask you about your symptoms, and medical and family history. The abdomen, pelvis, vaginal, and/or rectal areas will carefully examined to determine whether masses can be felt. If an abnormal growth is suspected, the following tests may be ordered to identify tumors, confirm diagnosis, and classify the cancer.

Tests Used to Assess Potential Bladder Cancer

Urine Tests

Urine tests will be done to check for the presence of blood, infection, or other abnormal cells in the urine. It may help identify or eliminate noncancerous causes of symptoms.

Cells found in the urine can be examined to look for the presence of abnormal (cancerous) cells. The cell testing called cytology will also help determine if the abnormal cells are from the bladder or other areas of the urinary tract like the kidneys.

Imaging Tests

Imaging tests may be used to look for the presence of tumors. It can also help assess the size and location of the tumor. Some tests use contrast material to highlight structures so images are more clear and detailed. Imaging tests may include:

Tests to Confirm Bladder Cancer

Cystoscopy with Biopsy

A cystoscopy is a minimally invasive procedure that passes a small scope through the urethra and into the bladder. The scope is then used to examine the inside of the bladder. A special medication may be used to help to see cancer cells. The medication is absorbed by the cancer cells which makes them glow under a special light.

A biopsy may also be done during the cystoscopy to confirm the presence of cancer. A biopsy is the removal of a small piece of suspicious bladder tissue for examination under a microscope. Biopsies can also help determine characteristics of the cancer and if it may have a higher rate of metastasis, which means they are more likely to spread elsewhere in the body.

In many cases, it is important to surgically remove the cancer from the bladder. This may involve removing all or part of the bladder, including the wall. Or, it may involve removing only the cancer itself from the inside of the bladder, leaving the bladder otherwise intact. In such a situation, the cystocope is used to perform a transurethral resection of the tumor. Transurethral means that it is not performed with an open abdominal incision. Instead, the tumor is removed through the urethra.

Results from this procedure will help to determine if your tumor is localized or whether it has begun to invade the bladder wall. While information from the removal of the bladder tumor helps determine an appropriate treatment plan, it is also an important step in your treatment. If transurethral resection shows that the tumor has invaded the bladder wall, more extensive treatment can be planned.

Staging and Prognosis of Bladder Cancer

Staging is a classification of cancer. It is based on if and how far the cancer has spread.

If cancer is found, the prognosis and treatment depends on the location, size, and stage of the cancer, and overall general health. Additional tests to determine the cancer’s stage may include:

  • Blood tests
  • Imaging tests including CT scan, MRI scan, or bone scan
  • Biopsy
  • Surgical reports—if tumor is surgically removed the doctor will note how much of the bladder tissue was involved

If bladder cancer is diagnosed, the following staging classification is used to identify how and where the cancer has spread:

  • Stage 0, also called carcinoma in situ—In this stage, abnormal cells are found only in the innermost lining of the bladder.
  • Stage I—Cancer cells are identified in the bladder’s deeper tissues, but not in the bladder’s layer of muscle.
  • Stage II—Cancer cells can be found in the bladder’s muscles.
  • Stage III—Cancer cells have spread to the outermost layer of the bladder, and may have invaded the prostate in men or the cervix, uterus, or vagina in women.
  • Stage IV—Cancer cells have spread to the tissue that lines the wall of the abdomen and/or pelvis. There may be cancer cells identified within lymph nodes and/or in distant locations, such as the liver, lungs, or bone.

Stages of Bladder Cancer
Stages of Bladder Cancer
Copyright © Nucleus Medical Media, Inc.

Revision Information

  • Bladder cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003085-pdf.pdf. Accessed June 29, 2015.

  • Bladder cancer. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 14, 2015. Accessed June 29, 2015.

  • Bladder cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/genitourinary-disorders/genitourinary-cancer/bladder-cancer. Updated November 2013. Accessed June 29, 2015.

  • General information about bladder cancer. National Cancer Institute website. Available at: http://www.cancer.gov/types/bladder/patient/bladder-treatment-pdq. Updated May 29, 2015. Accessed June 26, 2015.

  • Stages of bladder cancer. National Cancer Institute website. Available at: http://www.cancer.gov/types/bladder/patient/bladder-treatment-pdq#section/%5F109. Updated May 29, 2015. Accessed June 29, 2015.