Diagnosis Testing
When bladder cancer is suspected, a comprehensive evaluation is performed. Such an evaluation would include:
Typically the diagnosis testing occurs in this order:
- Radiological Imaging - the kidneys, ureters and bladder are evaluated for signs of cancer (e.g. Intravenous pyelogram or CT scan). These tests are performed in the office of a radiologist.
- Cystoscopy - Cystoscopy is performed in my office by inserting a viewing instrument called a cystoscope through the urethra and into the bladder. Looking through the cystoscope, I will be able to examine the entire inner surface of the bladder for signs of cancer. If any suspicious areas are observed, their appearance, number, location and size are noted and you will be scheduled for a transurethral resection. (see below).
- Transurethral Resection - a surgical procedure performed under anesthesia through the urethra to biopsy and remove suspicious areas found under cytstoscopy. The removed tissue is submitted for pathologic examination to determine if there is cancer and, if so, its stage and grade.
- Urine Cytology - This is administered by collecting a urine specimen. The urine is sent to an examining pathologist to be examined under a microscope, looking for cancer cells that may have been shed into the urine from the bladder lining and may not be seen during cystoscopy.