There are several tests that can determine the diagnosis of bladder cancer. A variety of tests may be used to make an exact diagnosis of bladder cancer.
Pathology Tests
Screening typically begins with pathology tests, where samples of fluid and tissue are examined by a pathologist in a laboratory.
- The most efficient, noninvasive and inexpensive test is a urinalysis/cytology. Here, a sample of urine is taken from the patient and evaluated for cancer cells, red and white blood cells (which fight urinary tract infections), and microscopic hematuria or infection. Hematuria (blood in the urine) is also a sign of a possible urinary tract infection.
- If abnormalities are found in the urine, a biopsy will be performed, in which a pathologist examines tissue for the presence of cancer cells. If the urine culture fails to show abnormalities, a biopsy or other tests still may be ordered — especially if there are symptoms of concern.
Imaging Tests
Imaging tests may be used to locate blockages and tumors, and determine whether cancer has spread to other organs.
- An intravenous pyelogram is an imaging test during which the patient is injected with dye and the radiologist observes with an X-ray the movement of that dye through the urinary tract. This X-ray will look at the collecting system of the kidneys to determine the presence of any irregularities. This is good for seeing small cancer locations and the upper urinary tract, and especially for detailing the kidneys, ureters and bladder.
- CT or CAT scans are another form of X-ray, which creates a more detailed image of the body and organs. This is used to locate kidney or bladder blockages, and to determine staging, recommended therapy and whether the bladder cancer has metastasized (spread to other parts of the body).
- MRI is another imaging form that creates very high-quality and detailed images of bladder tumors in addition to adjacent organs, such as the chest, pelvis and abdomen, to locate any metastasis.
- Ultrasound imaging, without side effects or radiation, is noninvasive and looks primarily at the bladder and kidneys. It can locate small tract blocks and stones, and also measures the bladder wall thickness.
- The gold standard for the evaluation of the lower urinary tract is a routine outpatient procedure called a cystoscopy. In the same way that a colonoscopy allows doctors to see inside the lower digestive tract, a cystoscopy provides a visual of the lower urinary tract and bladder lining.
During the procedure, a specialized instrument called a cystoscope is passed through the urethra into the bladder. Cystoscopes are either rigid or flexible. Fiber optics allow for images of the bladder lining to be created. If abnormalities, such as tumors, stones or patches of abnormal-appearing tissue, are discovered during cystoscopy, a biopsy may be taken. The biopsy specimen will then be evaluated by a pathologist for the presence of cancerous cells.
- Occasionally, the urologist will take a biopsy during a transurethral resection of bladder tumor procedure, which will be scheduled for a future appointment. This is a minimally invasive procedure that does not involve making an incision in the body. The entire removal of a bladder-confined tumor can be accomplished through an operative scope, which passes through the urethra into the bladder.
Bladder Cancer | John's Story
After being diagnosed with bladder cancer by a urologist close to home, John was determined to receive care from an institution with a solid reputation and the most advanced diagnostic and treatment options. This led him to find Trinity Bivalacqua, M.D., Ph.D., of the Johns Hopkins Greenberg Bladder Cancer Institute.
FAQs
Urine cytology remains the gold standard for bladder cancer screening. It is the test against which all others are compared when evaluating potential bladder tumor markers.
Would bladder cancer show up in urine test? ›
Urinalysis can help find some bladder cancers early, but it has not been shown to be useful as a routine screening test. Urine cytology: In this test, a microscope is used to look for cancer cells in urine. Urine cytology does find some cancers, but it's not reliable enough to make a good screening test.
What is usually the first symptom of bladder cancer? ›
For most people, the first symptom of bladder cancer is blood in the urine, also called hematuria. Sometimes the blood is visible, prompting the patient to visit a doctor.
What test is most definitive in diagnosing bladder cancer? ›
If bladder cancer is suspected, a biopsy is needed to be sure of the diagnosis. The procedure used to biopsy an abnormal area is a transurethral resection of bladder tumor (TURBT), also known as just a transurethral resection (TUR).
What is the marker for bladder cancer? ›
NMP-22 is thought to be released from the nuclei of tumor cells after they die and can be detected in the urine. Research has found that persons with bladder cancer may have urinary NMP-22 levels up to 25 times that in healthy persons.
What does Stage 1 bladder cancer feel like? ›
The first sign of bladder cancer is blood in the urine, which is painless for most people. In the early stages, this may be your only symptom, though some people don't experience it. Other symptoms include changes in bladder habits, frequent urinary infections, and pelvic or back pain, which might be on one side.
How long can you have bladder cancer without knowing? ›
Can bladder cancer go undetected for years? If symptoms such as blood in the urine and changes in urinary habits are ignored by an individual and/or repeatedly misdiagnosed, it's possible that bladder cancer may not be detected for months or, in some cases, even years.
What Colour is urine with bladder cancer? ›
The symptoms of bladder cancer can vary from person to person. The most common symptom is blood in the urine, called hematuria. It's often slightly rusty to bright red in color. You may see blood in your urine at one point, then not see it again for a while.
Is bladder cancer usually curable? ›
Non-muscle-invasive bladder cancer can often be cured. For muscle-invasive bladder cancer, prognosis also depends on whether carcinoma in situ is also present.
Do you feel unwell with bladder cancer? ›
If your bladder cancer has spread you might: have bone, back or tummy pain. feel very tired (fatigue) feel generally unwell.
The 5-year relative survival rate of people with bladder cancer that has not spread beyond the inner layer of the bladder wall is 96%. Almost half of people are diagnosed with this stage. If the tumor is invasive but has not yet spread outside the bladder, the 5-year relative survival rate is 70%.
How does a urologist check for bladder cancer? ›
Cystoscopy helps to diagnose, and sometimes treat, bladder cancer and other conditions. Cystoscopy. A cystoscope (a thin, tube-like instrument with a light and a lens for viewing) is inserted through the urethra into the bladder.
Where is the first place bladder cancer spreads? ›
Where can bladder cancer spread to? Not all bladder cancers will spread. But If it does it's most likely to spread to the structures close to the bladder, such as the ureters, urethra, prostate, vagin*, or into the pelvis. This is called local spread.
How quickly does bladder cancer spread? ›
It typically doesn't spread very quickly. However, other types of bladder cancer, such as adenocarcinoma, squamous cell carcinoma, and small cell carcinoma, spread much faster. In most cases, treatment, if started early enough, can prevent the spread of bladder cancer.
How accurate is CT for bladder cancer? ›
How effective are CT scans at detecting bladder cancer accurately? CT scans are very effective at detecting urinary tract cancers. A 2018 study found that CT urographies had a 91.5% accuracy rate.
How accurate is CT scan for bladder cancer? ›
While a CT scan can detect larger bladder tumors, it is not sensitive enough to detect small tumors or flat tumors in the bladder. CT is most useful to evaluate the kidneys and ureters and the area around the bladder and lymph nodes, as well as evaluate other organs in the body.
Is a CT scan good for detecting bladder cancer? ›
A CT scan may be used to see whether bladder cancer has invaded the bladder wall or has spread to other organs or nearby lymph nodes. Lymph nodes are small immune system glands that are often the first place cancer spreads, causing them to enlarge.
What is the FDA approved test for bladder cancer? ›
NMP22 stands out as the protein that has been the most extensively investigated and has been used to diagnose bladder cancer and monitor its recurrence. Both the NMP22 Bladder Cancer ELISA, a quantitative test, and the NMP22 BladderChek, a point-of-care test, have received FDA approval for surveillance [76].
