Bladder Cancer Diagnosis
Comprehensive Bladder Cancer Diagnostic Evaluations and Testing
Effectively treating bladder cancer requires a thorough diagnostic evaluation, with the precise location of all tumors. The University of Michigan Rogel Cancer Center offers the most advanced diagnostic tests and imaging services to help our multidisciplinary care teams design the most effective treatment course for each patient.
Diagnosis begins with a physical examination and discussion of all symptoms, followed by a urine test, called cytology. This will help detect cancer cells in the urine. Additional imaging tests are then typically required, along with an internal examination of the bladder.
These initial tests can usually be performed by one of our highly-trained and skilled urologists at a clinic near your home.
Symptom Analysis and Complete Physical Evaluation
Unlike other urologic cancers, there isn’t a screening test or evaluation available to help detect bladder cancer early. Most patients with bladder cancer have some or all of these symptoms:
- Bladder pain
- unexplained weight loss
- Microscopic or obvious blood in their urine
- Urinary frequency/urgency
These symptoms can mimic urinary tract infections, enlargement of the prostate in men, or common lower urinary tract symptoms in women. Often patients are treated for these more common problems first, leading to a delay in diagnosis. However, blood in the urine is never normal and should not persist after a short interval of treating for more common diseases, such as kidney stones.
If symptoms persist or re-occur, especially blood in the urine, then further evaluation from a specialist is crucial.
Comprehensive Imaging and Other Diagnostic Tests
At the U-M Rogel Cancer Center, a urologist will discuss your symptoms with you and perform a physical examination. Other tests that may be performed include:
- Cytology: A urine test to detect cancer cells in the urine, similar to a Pap smear that detects cervical cancer in women. This test takes two or three days for a result, however, and in many cases is inconclusive.
- Imaging: Most patients will require an imaging test that looks at the lining of the bladder. These tests may include a computed tomography (CT) scan, magnetic resonance imaging (MRI), or ultrasound. CT is the preferred test.
- Cystoscopy: This test is performed by placing a tiny flexible lighted telescope into the urethra in the clinic and inspecting the urethra and bladder. If a tumor is seen or a suspicious area is identified, your doctor will then schedule a second flexible cystoscopy to be performed in the operating room under anesthetic. This allows for tumor removal, diagnosis and in some cases further therapeutic treatment. This procedure can also be performed in the clinic setting as part of a surveillance plan for already-diagnosed patients.
Advanced Diagnostics with Blue Light Flexible Cystoscopy
Blue light cystoscopy is a newer type of flexible cystoscopy that is available through the University of Michigan Rogel Cancer Center for both diagnosis and treatment. Using the blue light technique versus a white light has been shown to improve diagnosis accuracy, as well as delay tumor recurrence.
Blue light cystoscopy uses a special chemical (Cysview®) that is absorbed by tumors. This makes tumor cells appear as bright blue tissue in the bladder. As a result, a small tumor that is difficult to see becomes much more obvious. Other benefits of blue light cystoscopy include:
- Slower tumor recurrence: A study found bladder tumor recurrence took seven months longer with the blue light technique, allowing patients to avoid invasive procedures and potentially reducing the frequency of bladder checks.
- Better high-risk identification: The blue light technology is able to identify high-risk tumors in addition to low-risk tumors. Early detection of this type of tumor means patients can begin treatment quicker, when there’s the greatest chance for a cure.
Multidisciplinary Team Approach for Bladder Cancer Care
The Rogel Cancer Center follows a multidisciplinary team approach to bladder cancer care. Your comprehensive diagnostic evaluation – including a review of all test and imaging results – will involve input from many highly trained and skilled specialists. Your urologist will work with oncologists, radiologists, pathologists and other cancer experts to form a complete diagnosis and an effective, personalized treatment plan.
Our teams work together as a coordinated team to provide you with prompt answers and guidance with fewer appointments.
Schedule an Appointment With the Bladder Cancer Clinic or Ask a Question Today
Our Cancer AnswerLine™ is staffed by oncology nurses who can answer your questions or assist you in making an appointment. Please call 800-865-1125 to get the appointment process started, or for answers to your questions. Or, visit our Bladder Cancer Appointments page.