Bladder Cancer Tests

How Is Bladder Cancer Detected And Diagnosed?

Once you notice symptoms, or as part of a routine examination, your doctor may use the following tests to look for bladder cancer:

  • Physical exam
  • Internal exam: The doctor inserts gloved, lubricated fingers into the vagina or rectum to feel for lumps in the bladder.
  • Urine lab test: A sample of your urine is taken and examined for cancerous or precancerous cells or biomarkers indicating bladder cancer.
  • Biopsy: Surgical removal of suspicious tissues for further examination
  • Cystoscopy: A thin, flexible tube (cystoscope) equipped with a lens and light source is inserted into the urethra and guided into the bladder. The bladder is then filled with fluid and examined for abnormalities. If suspicious tissues are seen, it may be biopsied for further examination. Localized, spinal or general anesthesia may be administered prior to this procedure.
  • Fluorescence cystoscopy: Also known as blue light cystoscopy, this enhanced form of cystoscopy uses a light-activated drug. The drug is taken up by cancer cells and glows when a blue light is shone upon it, allowing for easier detection of cancerous areas.


What Is Blue-Light Cystoscopy With Cysview?

Blue-Light Cystoscopy with Cysview is an advanced approach for the detection and diagnosis of bladder cancer. Our team is using this enhanced imaging technique to precisely identify and remove cancerous lesions on the bladder.

Used as an adjunct to white-light cystoscopy, Blue-Light Cystoscopy with Cysview is the only Food and Drug Administration-approved technology that:

  • Detects more Ta/T1 bladder cancer lesions than does white-light cystoscopy alone
  • Leads to improved tumor resection, since every tumor detected is resected in the same TURB (transurethral resection of the bladder)
  • Allows for better patient management decisions

If cancer is found, additional tests are performed to determine the type and stage of disease.

These Diagnostic Tests Include:

  • Intravenous pyelogram (IVP): Also called intravenous urogram (IVU), this procedure first injects a special dye into the vein. The dye then coats the interior lining of the urinary tract and an X-ray is taken to see if there are any tumors in the bladder, kidneys or ureters.

  • Retrograde pyelogram: For patients who cannot tolerate an IVP, this test injects the dye using a urinary catheter.
  • Computed tomography (CT or CAT) scan: This test involves taking a series of X-ray images at different angles to form a computer-generated image, which determines tumor size, location and number. CT scans may also be used to guide a biopsy.
  • Ultrasound: High energy sound waves are used to create images of the bladder, and it may be also be used to guide a biopsy.
  • Magnetic resonance imaging (MRI) urogram: This procedure images the bladder, ureters and kidneys using a powerful magnet, radio waves and a computer. A biopsy may be taken at the same time if the images show any abnormalities.
  • Lymph node biopsy: Removal and examination of lymph nodes in the pelvic region to see if the cancer has spread
  • Bone scan: A procedure using a small amount of radioactive material to determine if bladder cancer cells have spread to the bones
  • Genomic testing: The cancerous tissue is tested to see if it exhibits certain genetic mutations, which can be used to determine better treatments.

Based on the results of these tests, the bladder cancer is then staged according to its size, number of lymph nodes affected and whether it has spread to nearby or distant organs. Bladder cancer is also evaluated by “grades” based on how much it resembles normal bladder cells and how aggressive it grows.

Stages Of Bladder Cancer

After bladder cancer has been diagnosed, tests are done to find out if cancer cells have spread within the bladder or to other parts of the body. There are three ways that cancer spreads in the body: into nearby tissue, into the lymph vessels to other parts of the body and into blood vessels to other parts of the body.

The following stages are used to describe the location and extent of bladder cancer:

  • Stage 0 (papillary carcinoma and carcinoma in situ): In stage 0, abnormal cells are found in tissue lining the inside of the bladder. These abnormal cells may later become cancer and spread into nearby normal tissue.
  • Stage I: Cancer has formed and spread to the layer of connective tissue next to the inner lining of the bladder.
  • Stage II: Cancer has spread to the layers of muscle tissue of the bladder.
  • Stage III: Cancer has spread from the bladder to the layer of fat surrounding it and may have spread to the reproductive organs (prostate, seminal vesicles, uterus or vagina).
  • Stage IV: Cancer has spread from the bladder to the wall of the abdomen or pelvis, one or more lymph nodes and/or other parts of the body, such as the lungs, liver or bones.

What Are The Current Screening Guidelines For Bladder Cancer?

There are currently no screening guidelines for bladder cancer, since no screenings have been shown to lower risk of dying from bladder cancer for people of average risk. However, your physician may recommend screening if you are at a high risk of developing bladder cancer, due to:

  • Specific genetic mutations
  • Birth defects
  • Workplace chemical exposure