Consulting a medical professional is recommended if any changes in your urinary habits or in the appearance of your urine are noticed.

Anyone with a family or personal history of bladder cancer should promptly react to any of these changes by immediately visiting their healthcare provider.

Tests and Exams

A healthcare professional may examine the following in order to determine whether or not a bladder cancer is causing a patient’s symptoms:

• A physical examination, including rectal exams, pelvic exams for women, and prostate exams for men, may indicate the presence of a cancer.
• A patient’s family and/or personal history of bladder cancer, as well as their smoking history and possible exposures to harmful chemicals, may indicate a bladder cancer.
• A urine test is usually conducted in order to detect the presence of blood and other abnormalities in the urine.

If the above tests and exams suggest the presence of a bladder cancer, the following tests may be performed:

• Cytoscopy. This test allows a physician to see inside a patient’s bladder with the aid of a small, flexible, lighted scope (cytoscope). During this procedure, the cytoscope can also be used to remove small amounts of abnormal tissue (biopsy) for a microscopic evaluation (histological exam).
• A complete blood count (CBC) is usually recommended to determine if the patient has anemia.
• Computed tomography (CT urogram) is an imaging technique used to detect masses near the bladder, kidneys, or ureters.
• Pelvic ultrasounds – the same technology used to observe a fetus in the uterus of a pregnant woman – can be used to detect masses in the abdomen.

If an analysis of the above tests confirms the presence of a bladder cancer, the following tests may be recommended in order to ascertain further information of the state of the disease:

• Magnetic resonance imaging (MRI) will determine whether or not the cancer has spread to other areas in the body.
• Bone scans can be used to detect metastasis in the bones.
• Chest x-rays are performed to detect metastasized cancer in the lungs.
• Colonoscopies are performed to determine whether or not the cancer is affecting the intestines.

Staging of Bladder Cancer

A comprehensive analysis of all of the diagnostic and post-diagnostic tests will determine a cancer’s stage. In essence, a cancer’s stage identifies its location, size, and behavior. An understanding of these features will play a vital role in the management and treatment of the disease.

The following stages are used to define a bladder cancer:

• Stage 0: This stage indicates the presence of abnormal cells lining the inside of the bladder that have the potential to become cancerous. This stage is divided into two sub-stages:
• Stage 0a: This stage indicates the presence of small papillary carcinomas (mushroom-like growths) lining the inside of the bladder.
• Stage 0is: If the tumor lining the inside of the bladder is flat, unobtrusive, and very small, then it is termed carcinoma in situ, or Stage 0is.
• Stage I: Bladder cancers in this stage have spread to tissues under the bladder’s inner lining.
• Stage II: This bladder cancer has spread to the inner half or the outer half of the bladder’s muscle wall.
• Stage III: If the cancer has spread beyond the bladder into the fatty layer of tissue surround the organ, it is considered to be a Stage II cancer.
• Stage IV: This bladder cancer has spread to the wall of the abdomen or pelvis, and may have spread to one or more lymph nodes, or to another location in the body.