Bladder Cancer

Diagnosis

Diagnosis of bladder cancer can be done through the following methods:

• Physical examination and medical history: The patients will undergo a detailed physical examination to determine the potential causes of symptoms experienced by the patients. The patients may be asked about the duration of symptoms or if they feel the progression or worsening of the symptoms. Patients may also undergo rectal examination and pelvic examination (in the case of women) to detect any tumor. If there is any suspicion of bladder cancer or other diseases, the patient is recommended to undergo further testing.
• Cystoscopy: Cystoscopy is the procedure that allows cancer specialists to look into the bladder and urethra to detect bladder cancer or any other abnormal tissues which is causing the symptoms. The procedure involves using a cystoscope, a long, thin tube with a video camera attached at the end. The tube also comprises tools that help remove the abnormal tissues (if seen) for further examination. Cystoscopy assists in diagnosing bladder cancer and helps in treating bladder cancer in some cases. The patients may also undergo blue light cystoscopy or fluorescence cystoscopy along with standard cystoscopy to visualize the bladder tissue in more detail.
• Urinary analysis: Urine analysis is performed to determine the functional status of the kidney. Any abnormal substance in the urine may indicate kidney disease.
• Urine cytology: Cytological evaluation of the urine is also performed to determine the types of cells present. The goal of urine cytology is to look for the cancer cells in the urine that may have been shed from the tumor and drained with urine.
• Urine culture: The patients may also have a urine culture to rule out any infection in the urinary tract. It is important to note that several symptoms of bladder cancer overlap with symptoms of urine infections.
• Urine marker tests: Several specific substances are synthesized by the bladder cancer cells and are released in urine. Urine marker tests tend to determine the presence of those substances in the urine. However, although these tests may help diagnose bladder cancers, they are not useful in all cases, as many patients with a lack of urine markers can still be diagnosed with bladder cancer.
• Pyelogram: Pyelogram is a procedure that involves evaluating the complete urinary tract after injecting a dye into the vein. The dye is filtered by the kidneys and then reaches the bladder and urethra. The dye outlines the tissues of the bladder and urethra and is visualized with x-rays. It helps in detecting any tumor in the bladder or urethra. Another method, known as retrograde pyelogram, is also used. It involves the use of a catheter, which is inserted into the urethra and guided to the ureter. The dye is then injected that outlines the tissues of the bladder or urethra.
• CT scan: A CT scan makes a complete cross-sectional image of the complete urinary tract and helps diagnose any tumor in the ureter, urinary bladder, and urethra. The CT scan also effectively detects enlarged lymph nodes or abnormal tissues in the pelvis or other abdominal organs.
• Ultrasound: Ultrasound assists the oncologists in determining the size of the bladder tumor and if the tumor has spread to the nearby lymph nodes, tissues, or organs. In some cases, ultrasound is also used for obtaining the tissue samples for further evaluation (ultrasound-guided biopsy).
• Chest x-ray: Chest X-rays are used to detect advanced bladder cancer. It is usually performed in patients already diagnosed with bladder cancer and believed to have lung metastasis.
• Bone scan: If the patients suspected to have or diagnosed with bladder cancer experience bone pain, the cancer specialists recommend a bone scan to rule out the spread of bladder cancer to bones.
• Biopsy: Biopsy is the procedure of obtaining samples of abnormal tissues and sending them to the laboratory for further examination. The procedure is done under image guidance. A biopsy is considered the confirmatory diagnosis of bladder cancer.