Bladder Cancer Diagnosis

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.