Your doctor will ask you about your symptoms and risk factors, and then perform one or more tests to diagnose your condition. These tests may include the following.
You doctor will perform an internal exam in the rectum or vagina to feel around the bladder to determine if any masses are present.
Urine Tests (Cytology)
Urine is tested for blood and to look for abnormal bladder cells that may be present.
Computerized Tomography (CT) Scans
A scan of the abdomen allows physicians to visualize the bladder and surrounding organs in a noninvasive manner.
A cystoscope, a long tube with a lens at the end, is directed into the bladder through the urethra. The cystoscope is used to visualize the inside of the bladder and can be used to collect a biopsy.
In this procedure, bladder tissue is removed from the body and viewed with a microscope by a pathologist. The pathologist will be able to determine if the cells are cancerous, and the grade (severity) of any bladder cancer cells that may be present.
After a diagnosis of bladder cancer, the physician must determine the stage (aggressiveness) of the tumor in order to treat it appropriately. This is performed by a surgery called transurethral resection of bladder tumor (TURBT) using a cystoscope under anesthesia. Here the tumor is resected and the depth of invasion into the bladder is assessed.
Bladder Cancer Stages
Bladder cancers are classified, or staged, based on their aggressiveness and how much they differ from the surrounding bladder tissue. There are several different ways to stage tumors. Recently, the TNM (Tumor, Nodes, Metastasis) staging system has become common. This staging system categorizes tumors using the following scale:
Noninvasive tumors that are only in the bladder lining
Tumor goes through the bladder lining, but does not reach the muscle layer of the bladder
Tumor goes into the muscle layer of the bladder
Tumor goes past the muscle layer into tissue surrounding the bladder
Tumor has spread to neighboring lymph nodes or to distant sites (metastatic disease)