See your doctor right away if you develop any of the signs or symptoms
of bladder cancer, including bloody, painful or frequent urination. Your
doctor will ask you about your medical history and perform a thorough
physical exam. This may include an internal examination during which
your doctor gently inserts a gloved, lubricated finger into your rectum
or vagina. To help diagnose bladder cancer, you may also have one or
more of the following tests:
Doctors are evaluating several new methods to determine if bladder
cancer can be accurately diagnosed using noninvasive methods,
including tests that check a sample of your urine for cancer
markers. One such marker is the enzyme telomerase, which is active
in malignant cells but inactive in normal cells. The FDA has also
approved two tumor marker tests that help diagnose recurrent bladder
cancer. Both of these tests involve checking a urine sample for
proteins associated with bladder tumors.
This X-ray allows your doctor to see an image of your kidneys and
lower urinary tract, including your bladder. You'll receive an
injection of a contrast dye through a vein in your arm. Your
bloodstream delivers the dye to your kidneys, ureters and bladder.
The contrast agent makes it easier for your doctor to see any
abnormalities or tumors on a series of X-rays.
In this procedure, your doctor inserts a narrow tube (cystoscope)
through your urethra. The cystoscope has a lens and fiber-optic
lighting system, allowing your doctor to see your urethra and
bladder. Your doctor can also use the cystoscope to remove a small
sample of tissue (biopsy) for analysis in the laboratory.
If you're found to have
bladder cancer, you're likely to have tests to
help determine whether the cancer has spread (metastasized) — a process
known as staging. The stage of cancer helps your doctor determine the
best course of treatment and the outlook for your recovery. Staging
tests may include one or more of the following:
is essentially a highly detailed X-ray that allows your doctor to
see your bladder in two-dimensional "slices." Split-second computer
processing creates these images while a series of thin X-ray beams
pass through your body. In most cases, you will have a contrast dye
injected into a vein before the test. The dye makes it easier for
your doctor to see your organs and to determine if anything abnormal
is present that might suggest cancer. Your greatest risk with this
procedure is a possible allergic reaction to the dye.
resonance imaging (MRI).
Instead of X-rays, this test uses a powerful magnetic field and
radio waves to create images of your urinary tract. During the test,
you're enclosed in a cylindrical tube that can seem quite confining
to some people. The machine also makes a loud thumping noise you
might find disturbing. In most cases you'll be given earplugs to
help block out the noise. If you're claustrophobic, ask your doctor
whether an open scan or some mild sedation may be an option for you.
This imaging test is used to determine whether cancer has spread to
your bones. During the procedure, a small amount of a radioactive
substance that collects in bone is injected into a vein in your arm.
A special scanner then takes pictures of all your bones.
This test may help detect cancer that has spread to the lungs.
How bladder cancer is staged
Bladder cancer is often staged using the numbers 0 to IV:
Stage 0 cancer.
Also called superficial or in situ cancer, this occurs only on the
surface of the inner lining of the bladder. Finding cancer at this
stage offers the best hope for a full recovery. Stage 0 cancer can
often be completely removed while sparing the bladder, but the rate
of recurrence is high.
Stage I cancer.
Cancer at this stage occurs in the bladder's inner lining, but
hasn't invaded the muscular bladder wall.
At this stage, cancer has invaded the bladder wall.
The cancer cells have spread through the bladder wall to surrounding
tissue. They may also have spread to the prostate in men or the
uterus or vagina in women.
By this stage, cancer cells may have spread to the lymph nodes and
other organs, such as your lungs, bones or liver.
This refers to cancer that has returned after having been treated.
It may recur in the same place or in another part of your body.
Bladder cancer can lead to anemia, urinary incontinence and hydronephrosis — a blockage of the ureters that prevents urine from
draining into your bladder. But the most serious complication is the
spread of cancer from the bladder to other organs.