If you have symptoms that may signal bladder cancer, your doctor will examine you and ask you questions about your health; your lifestyle, including smoking and drinking habits; and your family medical history.
One or more of the following tests may be used to find out if you have bladder cancer and if it has spread. These tests also may be used to find out if treatment is working.
Blood and urine tests: These tests can help doctors diagnose bladder cancer or identify other conditions that may be causing the symptoms, such as kidney stones, a urinary tract infection or an enlarged prostate.
Cystoscopy: This is the most frequent and reliable test for bladder cancer. It is sometimes paired with transurethral resection (TUR), a procedure to remove cancer cells from the bladder.
During a cystoscopy procedure, a thin tube with a camera on the end (cystoscope) is inserted into the bladder through the urethra. The cystoscope can be used to take a tissue sample and treat superficial tumors without surgery. Pathologists can then study the tissue cells under a microscope in order to make a diagnosis. However, cystoscopy is not always accurate when performed alone. Flat lesions (carcinoma in situ) and small papillary tumors can be missed. MD Anderson recommends that cystoscopy be combined with other tests for the most accurate diagnosis.
MD Anderson can offer cystoscopy with the patient under general anesthesia. This allows doctors to perform a more thorough exam of the bladder when needed.
MD Anderson also uses blue light cystoscopy to aid the detection of bladder tumors. During this procedure, the bladder is filled with a solution that is absorbed by cancer cells, then lights up when exposed to a blue light during a cystoscopy.
Imaging tests: Imaging exams for bladder cancer include:
- CT urogram. This is the most commonly used imaging test for bladder cancer.
- MRI (magnetic resonance imaging) scans. MRI may be used when a patient has poor kidney function and cannot take the contrasting dye required in a CT urogram.
- PET (positron emission tomography) scans
- Bone scan
- Chest X-ray or chest CT
Getting a second opinion at MD Anderson
The pathologists at MD Anderson are highly specialized in diagnosing and staging every type of bladder cancer. We welcome the opportunity to provide second opinions.
In rare cases, bladder cancer can be passed down from one generation to the next. Genetic counseling may be right for you. Visit our genetic testing page to learn more.
Bladder Cancer Staging
If you are diagnosed with bladder cancer, your doctor will determine the stage of the disease. Staging is a way of classifying how much disease is in the body and where it has spread when it is diagnosed. This information helps your doctor plan the best type of treatment for you.
Once the staging classification is determined, it stays the same even if treatment is successful or the cancer spreads.
Bladder Cancer Stages
(source: National Cancer Institute)
Stage 0: In stage 0, abnormal cells are found in tissue lining the inside of the bladder. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is divided into stages 0a and 0is, depending on the type of the tumor:
- Stage 0a is also called noninvasive papillary carcinoma, which may look like long, thin growths growing from the lining of the bladder.
- Stage 0is is also called carcinoma in situ, which is a flat tumor on the tissue lining the inside of the bladder.
Stage I: In stage I, cancer has formed and spread to the layer of connective tissue next to the inner lining of the bladder.
Stage II: In stage II, cancer has spread to the layers of muscle tissue of the bladder.
Stage III: Stage III is divided into stages IIIA and IIIB.
- In stage IIIA:
- cancer has spread from the bladder to the layer of fat surrounding the bladder and may have spread to the reproductive organs (prostate, seminal vesicles, uterus, or vagina) and cancer has not spread to lymph nodes; or
- cancer has spread from the bladder to one lymph node in the pelvis that is not near the common iliac arteries (major arteries in the pelvis).
- In stage IIIB, cancer has spread from the bladder to more than one lymph node in the pelvis that is not near the common iliac arteries or to at least one lymph node that is near the common iliac arteries.
Stage IV: Stage IV is divided into stages IVA and IVB.
- In stage IVA:
- cancer has spread from the bladder to the wall of the abdomen or pelvis; or
- cancer has spread to lymph nodes that are above the common iliac arteries (major arteries in the pelvis).
- In stage IVB, cancer has spread to other parts of the body, such as the lung, bone, or liver.
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