Learn The BasicsThere are several tests that doctors can run to diagnose bladder cancer in a patient.
These include urine tests, imaging tests and a cystoscopy. A doctor may also conduct a physical exam for the initial diagnosis of bladder cancer.
Physical exam
The first step in the diagnosis of bladder cancer sometimes involves an internal physical examination.
Here, the doctor inserts a gloved finger in the rectum or vagina and examines the bladder for any signs of a tumor. If they do feel something abnormal, they usually refer the patient to a specialist for further testing.
Urine tests
The most common symptom of bladder cancer is blood in the urine, which can sometimes make the urine appear bright red or dark brown in color. However, in some cases, the blood can only be detected through a urine test or urinalysis.
Another type of urine test that can be conducted to diagnose bladder cancer is called urine cytology. This test involves analyzing a urine sample under a microscope for the presence of cancer cells.
Finally, the urine might be tested for the presence of tumor markers such as bladder tumor antigen (BTA), also known as CFHrp, mucin, carcinoembryonic antigen (CEA) and NMP22 protein, the levels of which are elevated in patients with bladder cancer.
Imaging tests
Imaging tests that may be conducted to diagnose bladder cancer include computerized tomography (CT) urogram or retrograde pyelogram.
During a CT urogram, a contrast dye is injected into a vein in the patient’s hand and travels to the kidneys, ureters (the tubes connecting the kidneys to the bladder) and bladder. X-ray images of the urinary system can provide a detailed view of all the organs in the urinary system, including the bladder. A doctor can identify any cancerous areas by looking at these images.
A retrograde pyelogram also uses X-ray images. It can help doctors obtain a detailed image of the upper urinary tract. It involves the insertion of a thin tube called a catheter through the urethra (the tube through which urine leaves the body) into the bladder to inject contrast dye into the ureters, which then travels into the kidneys and is captured on the X-ray images.
Other imaging tests that may be conducted in case of bladder cancer include magnetic resonance imaging (MRI) and ultrasound. These tests are usually done to identify if the cancer has grown into the deeper muscle layers or spread to other areas in the body. CT scans of the pelvis, chest, and abdomen may also be conducted to check the spread of the cancer, along with a chest X-ray and a bone scan.
Cystoscopy
Cystoscopy is the most commonly used test to diagnose bladder cancer.
Here, the doctor inserts a narrow tube called a cystoscopy that carries a camera at the end into the bladder through the urethra.
This way, the inside of the bladder can be visualized and any areas that could be cancerous identified.
During a cystoscopy, a small sample of the lining of the bladder or a biopsy is also obtained. This sample is then sent to the pathology department to be analysed and allows for a definitive diagnosis of bladder cancer to be reached.