Bladder Cancer Diagnosis
Affiliated: Find a Doctor | Symptoms | Treatment | Diagnosis
Diagnosis of Bladder Cancer
Both urological and imaging tests are used to diagnose bladder cancer. These tests include the following:
- Physical exam – May include an internal exam in the rectum or vagina to feel around the bladder to determine if any masses are present.
- Urine tests – Urine is tested for blood and to look for abnormal bladder cells that may be present (cytology).
- Computerized tomography (CT) scans – A scan of the abdomen allows physicians to visualize the bladder and surrounding organs in a non-invasive manner.
- Transurethral cystoscopy – A cystoscope, a long tube with a lens at the end, is directed into the bladder through the urethra. The cystoscope is used to visualize the inside of the bladder and can be used to collect a biopsy.
- Biopsy – In this procedure, bladder tissue is removed from the body and viewed with a microscope by a pathologist. The pathologist will be able to determine if the cells are cancerous, and the grade/severity of any bladder cancer cells that may be present.
- After a diagnosis of bladder cancer, the physician must determine the stage (aggressiveness) of the tumor in order to treat it appropriately. This is performed by a surgery called transurethral resection of bladder tumor (TURBT) using a cystoscope under anesthesia. Here the tumor is resected and the depth of invasion into the bladder is assessed.
Staging of Bladder Cancer
TNM (tumor, nodes, metastasis) staging is utilized to classify the tumor in the following manner:
- Ta - Non-invasive papillary carcinoma limited to the superficial lining of the bladder (urothelium)
- Tis - Carcinoma in situ (CIS) – non-invasive flat carcinoma limited to the superficial lining of the bladder
- T1 - The tumor has grown into the urothelial lining (lamina propria) but not into the muscle layer
- T2 - The tumor has grown into the muscle layer (muscularis propria)
- T2a - Limited to the inner half of the muscle layer
- T2b - Extending to the outer half of the muscle layer
- T3 - The tumor has grown outside the bladder muscle into the fatty tissue that surrounds the bladder
- T3a - Extension into fatty tissue can only be seen by using a microscope
- T3b - Extension into fatty tissue surrounding the bladder is significant enough to be seen on imaging or to be felt by the surgeon
- T4 - The tumor invades into surrounding structures including the prostate, uterus, vagina, pelvic wall, or abdominal wall
- T4a - The tumor has spread to the prostate, uterus, or vagina
- T4b - The tumor has spread to the pelvic wall or the abdominal wall
- N0 - No regional lymph node spread
- N1 - Cancer has spread to a single lymph node that is 2 cm or smaller
- N2 - Cancer has spread to a single lymph node that is larger than 2 cm but not larger than 5 cm (2 inches) or cancer has spread to 2 or more lymph nodes, none of which is larger than 5 cm
- N3 - The cancer has spread to a lymph node that is larger than 5 cm
- M0 - No signs of distant spread
- M1 - Cancer has spread to distant lymph nodes, organs, or tissues (such as the bones, lungs, or liver)
Our Bladder Cancer Mission is You
Patient Story >
Adam Schaffer will never forget Thanksgiving Day 2007, when his then 6-year-old son accidentally kneed him in the groin during a playful bout of wrestling. A few hours later, Schaffer’s stream of urine was the color of blood..
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The Department of Urology at UCLA is one of the most progressive and comprehensive urology programs in the country. Our faculty members work side by side with research scientists for new cures and treatments for bladder cancer.
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Our goal is to provide you with fast, easy access to the physicians and services at UCLA. For assistance in determining which UCLA urologist(s) may have expertise to help you, please call the Urology Appointment phone number: (310) 794-7700