Diagnosis of Bladder Cancer

1) Radiology An Intravenous pyelogram (IVP) is a conventional x-ray test using dye to examine the pelves of the kidneys (where urine collects within the kidneys),ureters, and bladder. This x-ray allows visualization of the upper and lower urinary tract to determine the presence of any abnormality.
2) Computed Tomography (CT) scanning is essentially a detailed X-ray of the body. CT shows cross-sections of the body and allows your doctor to see details of the anatomy that would not be seen on regular x-ray.
3) Magnetic Resonance Imaging (MRI) is more sensitive than CT scanning. CT and MRI have the added benefit of detecting enlarged lymph nodes near the tumors, which can suggest that a cancer has spread (metastasized) to the lymph nodes.
4) Cystoscopy Cystoscopy is performed by the urologist. It evaluates the bladder by direct visual examination with a specialized instrument call a cystoscope, which is placed in the bladder via the urethra during the examination. The purpose of routine outpatient cystoscopy is to evaluate the lining of the lower urinary tract. If abnormalities such as tumors, stones, or patches of abnormal appearing tissue are discovered during cystoscopy, a biopsy may be taken at that time.
5) Pathology The diagnosis of bladder cancer is based on examining cells from the bladder, either from a urine specimen or biopsy of the bladder. Only a pathologist can diagnose if a bladder cancer is present and the type of bladder cancer, by looking at the bladder tissue. The correct diagnosis is critical, as appropriate treatment of bladder cancer is dependant upon the type of cancer seen. The pathology of the bladder is complex and therefore a second opinion is often advisable and can have a major impact in therapy. The diagnosis can sometimes be made by examining urine cytology. A cytopathologist looks at individual cells from the urine, which are spread into a thin layer onto glass microscopic slides. These procedures have the benefit of not requiring an operation or general anesthesia. Biopsy of the bladder, performed through the cystoscope, is the more common means of diagnosing these tumors. The pathologist will examine a small sample (a biopsy) of your bladder tissue under a microscope. The pathologist identifies whether the tumor is benign or malignant and the type of tumor. This is essential because tumors of different types behave very differently and require different treatment regimens.	Click to compare urine cytology Biopsy tissue showing bladder cancer