Carl R. Darnall Army Medical Center - Health Library

Diagnosis and Prognosis of Bladder Cancer

Your doctor will ask you about your symptoms, and health and family history. The belly, pelvic, vaginal, and rectal areas will be carefully checked. Testing will help narrow down the cause of the problems.

Suspicion of Bladder Cancer

You may need:

Urine Tests

This will look for blood, infection, or other abnormal cells in the urine.

Other tests will be able to tell if the abnormal cells are from the bladder or another area in the urinary system.

Blood Tests

Blood tests may find tumor markers in the blood. Markers and certain blood proteins may be higher than normal if there is cancer.

Imaging Tests

Imaging tests help look for tumors. They can also help find their size and where they are. Some tests use contrast agents to highlight structures. These make them easier to see. You may need a:

Diagnosis of Bladder Cancer

A bladder biopsy is done during cystoscopy. A small scope is passed through the urethra and into the bladder. Contrast agents may be used to make the cancer easier to see. Tissue samples are taken and looked at in a lab. This is the only way to make a diagnosis.

Staging of Bladder Cancer

Your test results and new tests will help find the stage of cancer. Staging is used to tell the tumor type. This helps with planning treatment. Staging can tell:

  • How far the original tumor has spread
  • Whether lymph nodes are involved
  • If cancer has spread to other tissue
  • Details about the cells

Bladder cancer is staged from 0-4.

  • Stage 0—Carcinoma in situ —A very localized group of cells that don’t appear normal. They're in the deepest lining of the bladder.
  • Stage 1 —Cancer cells are found in the bladder’s deeper tissues, but not in the bladder’s layer of muscle or any lymph nodes.
  • Stage 2 —Cancer cells have spread to the bladder’s muscles, but not in any lymph nodes.
  • Stage 3 —Cancer cells have spread through the muscular wall of the bladder to the layer of tissue surrounding the bladder OR possibly to the reproductive organs, including the prostate gland. No lymph nodes are involved.
  • Stage 4 —Cancer cells have spread to the tissue that lines the wall of the abdomen and/or pelvis. There may be cancer cells identified within lymph nodes and/or in distant locations, such as the liver, lungs, or bone.

Stages of Bladder Cancer
Stages of Bladder Cancer

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REFERENCES:

Bladder cancer. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/genitourinary-disorders/genitourinary-cancer/bladder-cancer. Updated October 2017. Accessed August 2, 2018.

Bladder cancer diagnosis and staging. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T921922/Bladder-cancer-diagnosis-and-staging. Updated June 26, 2018. Accessed August 2, 2018.

Stages of bladder cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/bladder/patient/about-bladder-cancer-pdq#section/_109. Updated May 3, 2018. Accessed August 2, 2018.

Tests for bladder cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/bladder-cancer/detection-diagnosis-staging/how-diagnosed.html. Updated May 23, 2018. Accessed August 2, 2018.

Last reviewed May 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP  Last Updated: 8/2/2018