Bladder Cancer
Diagnosis
Often, bladder cancer is asymptomatic until
there is advanced disease. Therefore, in such cases, screening must be performed
to detect the tumor. The most widely used screening tests are medical interview,
physical examination, urinalysis, urine cytology, and cystoscopy. These tests
are also used to diagnose bladder cancers symptomatic patients as well. The
doctor will review the patient's medical condition, work history, habits and lifestyle
so that he can develop and assess the risk for bladder cancer. A complete
physical examination is performed including rectal or vaginal exam. The physician
may insert a gloved finger into the vagina, rectum or both to feel for any lumps
that might indicate a tumor or another cause of bleeding. Urinalysis
: It is a collection of tests for finding abnormalities in the urine
such as blood, protein, sugar (glucose), and solids. Any abnormal findings should
be investigated with more definitive tests. Urine cytology
(Urine tests) : Abnormal cells or tumors in the bladder wall slough
off cells that are suspended in the urine and excreted from the body during
urination. In this test, a sample of the urine is examined under a powerful microscope
to look for abnormal cells that might suggest cancer. A urine culture may be done
to rule out an infection. The presence of certain antibodies and other markers
may indicate cancer. Cystoscopy : It is
the method of examining bladder and urethra using cystoscope, which is a thin,
narrow tube with a light and a camera on the end. Cystoscope is inserted into
the bladder through the urethra to examine any abnormalities such as tumors. The
camera transmits pictures to a video monitor, allowing direct viewing of the inside
of the bladder wall. With the cystoscope, sample tissues can be removed and it
is examined under a microscope to detect cancer. If bladder
cancer is suspected, further tests are performed. These includes : Pyelography
: It is a series of x-rays of the kidneys, ureters, and bladder.
The doctor will inject a special dye into a vein (intravenous pyelography or IVP)
or into the urethra (retrograde pyelography) and x-ray film of the urinary tract
is taken. The dye highlights the organs of the urinary tract and makes seeing
certain abnormalities easier. CT (Computerized tomography)
Scan : Similar to an x-ray film, CT gives a 3-dimensional view
of the bladder, urinary tract (especially the kidneys), and pelvis to look for
masses and other abnormalities. In most cases, before the test, a contrast dye
is injected into a vein to highlights the organs. The greatest risk with this
procedure is a possible allergic reaction to the dye. Biopsy
: Biopsy is the removal of tissue to look for cancer cell.
It is the only sure way to tell whether cancer is present. Tiny samples of the
bladder wall are removed, usually during cystoscopy. The samples are examined
under a microscope. Small tumors are sometimes completely removed during the biopsy
process. If bladder cancer is identified, certain other
tests may be performed to find whether it has invaded the bladder wall or spread
to other parts of the body. It is called staging and the tests may include CT
scan, ultrasound scan, magnetic resonance imaging (MRI), sonogram, bone scan or
chest x-ray. Ultrasound Scan : This scan can
show the size and how far the tumor has spread to other organs. In this
painless test, a handheld device run over the surface of the skin uses sound waves
to examine the contours of the bladder and other structures in the pelvis. Chest
x-ray film : A simple x-ray film of the chest is taken to check
whether the bladder cancer has spread to the lungs. Magnetic
resonance imaging (MRI) : Instead of X-rays, MRI uses a powerful
magnetic field and radio waves to create the image of urinary tract. Bone
scan : This imaging test is used to determine whether cancer has
spread to your bones. In this method a tiny amount of a radioactive substance
is injected into the veins. A special scanner then takes pictures of all your
bones. |