If you and your health care provider believe that you have a problem, you may be referred to a urologist. A urologist is a doctor who specializes in problems of the urinary system and male reproductive system.
There is no single test to check for bladder cancer. If you have symptoms of bladder cancer, your doctor may perform 1 or more of the following tests.
Medical History and Physical Exam
Your doctor will ask about your contact with things known to cause bladder cancer such as tobacco smoke (from your own use or secondhand smoke) or chemicals. You will also be asked if there is a family history of bladder cancer. Your doctor will check you for signs of disease.
For this test you will provide a urine sample. Specialists will check the color of the urine and its contents. They may also perform urine cytology. For this, your urine is viewed under a microscope to look for cancer cells test . Urine can also be tested for other things linked with cancer cells (tumor markers).
Your doctor may request a computerized tomography (CT) scan. These scans are like X-rays, but they take more detailed pictures of your organs. Your doctor may order images of the kidneys, ureters and bladder to check for problems. If there is blood in the urine, it could have come from anywhere in the urinary tract. The scans will help the doctor see the problem. This is most often done with a CT urogram (CT scan focused on the urinary tract).
Cystoscopy allows your doctor to see directly inside the bladder and inspect the inner surfaces for signs of cancer. It is most often done in the doctor's office. To make the test more comfortable, you will have local anesthesia (medicine to block pain in the area) or light sedation (to help you relax and to block pain). In some cases you may receive general anesthesia (to put you to sleep).
The urologist uses a cystoscope, which is a soft, thin tube with a light and a lens or a small video camera on the end. The cystoscope is moved through the opening of the urethra (where urine leaves your body) and into the bladder. The scope inserts sterile salt water to expand the bladder. This allows the doctor to get a better look at the bladder lining.
If tumors are present, the doctor notes their appearance, number, location and size.
Because removal (resection) of the tumors often cannot be done with local anesthesia alone, you may be scheduled to return for surgery to remove the tumor under general or spinal anesthesia. This surgery is called transurethral resection of bladder tumor (TURBT). (See Treatment section for more information on TURBT.)
If you are put to sleep for cystoscopy , your doctor can also do a biopsy. A biopsy is when samples of tissue are removed to see if cancer is present. A pathologist (a specialist who identifies changes in body tissue) examines the tissue under a microscope to check for cancer cells.
To remove tissue, the doctor inserts a resectoscope through the urethra into the bladder. This is a viewing instrument similar to the cystoscope, but it contains a wire loop at the end to remove the tissue.