When symptoms develop that are associated with bladder cancer, patients are referred to a urologist, a doctor that treats disease of the urinary tract. Your doctor will likely perform an office-based procedure called a cystoscopy to further evaluate your bladder. A cystoscope is a small flexible tube with camera that is inserted into the urethra and passed into the bladder. Your doctor will be able to visualize the entire bladder and urethra during this examination to determine if there is a tumor present. While this procedure can provoke anxiety, it is tolerated very well. You will be able to drive home after the office procedure without difficulty.
If your doctor detects a tumor, they may biopsy this tumor in the office or recommend an outpatient surgery to remove the tumor in order to diagnose bladder cancer.
Currently there are not blood tests that are used to diagnose bladder cancer. There are urine tests which can be used to help detect or suggest that cancer is present, but these tests are not used by themselves in order to diagnose bladder cancer.
Additional tests that are used during the workup and evaluation of bladder cancer is a CT scan. 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. The combination of CT scan and cystoscopy are used to evaluate the entire urinary tract. This is important because approximately 5% of patients with bladder cancer will also have tumors in the ureter or kidney. Sometimes ultrasound is also used to evaluate the kidneys, but this test is not as sensitive as a CT scan and is not frequently used for the diagnosis of bladder cancer.
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