Understanding Bladder Cancer -- Diagnosis and Treatment
How Is Bladder Cancer Diagnosed?
To diagnose bladder cancer, your doctor completes a thorough medical history and examination. You will then be referred to a urologist, a physician who has special training in managing diseases of the bladder.
The first test the urologist may perform is an intravenous pyelogram (IVP), followed by a cystoscopy. During a cystoscopy, the urologist will pass a cystoscope (a fiber-optic lighted tube) through the urethra in order to view the bladder. A urine sample for cytology will be obtained and a brush biopsy will be performed, a combination approach that increases the probability of an accurate diagnosis.
If the doctor sees anything unusual during the cystoscopy, like a tumor, a tiny tissue sample is taken through the tube and examined in the laboratory. The doctor should also perform a bimanual examination to determine if there is a mass that can be felt and whether the bladder is mobile or fixed. Should a tumor be malignant, the treatment will depend on how far, if at all, the cancer has spread.
Blood and urine studies (to look for cancer cells and infection) and imaging studies with a chest X-ray, a CT scan of the abdomen and pelvis, and possibly a bone scan will be taken to determine the extent, or stage, of the bladder cancer.
What Are the Stages of Bladder Cancer
These are the stages, or measure, of how widespread the bladder cancer is:
TX. The primary tumor cannot be assessed.
T0. There is no evidence of a primary tumor.
Stage Oa. This is a designation for non-invasive papillary cancer.
Stage 0 or carcinoma in situ. This is early bladder cancer that just affects the inner lining of the bladder and is designated as non-invasive.
Stage I. Here, the cancer has spread deeper into the lining of the bladder but doesn't affect the muscle wall of the bladder.
Stage II. The cancer affects the inside part of the muscles of the bladder and is designated as invasive.
Stage III. The bladder cancer has spread through the muscle wall of the bladder and may be affecting the tissue that surrounds the bladder or the reproductive organs.
Stage IV. The cancer has spread outside the bladder to surrounding lymph nodes or organs.
Recurrent Bladder Cancer. This means that the cancer has come back after treatment.
If diagnosed early, superficial tumors can usually be treated successfully by transurethral resection (TUR). In this procedure, the surgeon inserts a small tube into the bladder through the urethra and removes the tumor surgically or burns it out with heat or a laser. Using this approach, the abdomen isn't cut. The side effects are usually mild and short-lived and include bleeding and mild pain. You'll be able to go home within a day of the procedure.