• Diagnosis and Prognosis of Bladder Cancer

    Your doctor will ask you about your symptoms, and medical and family history. The abdominal, pelvic, vaginal, and/or rectal areas will be carefully examined. Your doctor may recommend different tests in order to identify tumors and confirm diagnosis.

    Suspicion of Bladder Cancer

    If you are having urinary symptoms, your doctor may conduct certain tests to identify abnormalities. These may include:
    Urine Tests
    Urine tests check for the presence of blood, infection, or other abnormal cells in the urine. They may help identify or eliminate noncancerous causes of symptoms.
    Cells found in the urine can also be examined to look for the presence of abnormal or cancerous cells. Cell testing (called cytology) will also help determine if the abnormal cells are from the bladder or other areas of the urinary tract, like the kidneys.
    Blood Tests
    Blood tests may identify markers in the blood. For example, tumor markers or specific blood proteins may be elevated in the presence of cancer.
    Imaging Tests
    Imaging tests may be used to look for the presence of tumors. They can also help assess their size and location. Some tests use contrast material to highlight structures so images are more clear and detailed. Imaging tests may include:

    Diagnosis of Bladder Cancer

    A bladder biopsy is done during cystoscopy. Cystoscopy involves passing a small scope through the urethra and into the bladder. Contrast material may be used to highlight cancer cells. During a biopsy, suspicious tissue is removed so it can be examined under a microscope. This is the only way to confirm a diagnosis.

    Staging of Bladder Cancer

    If bladder cancer is confirmed, results from completed tests and new tests will help determine the stage of cancer. Staging is used to identify characteristics of the tumor that will help determine the prognosis and treatment plan. Factors that play a role in staging include how far the original tumor has spread, whether lymph nodes are involved, if cancer has spread to other tissue, and microscopic cellular details.
    Bladder cancer is staged from 0-IV.
    • Stage 0—Carcinoma in situ—A very localized group of abnormal cells are found in the innermost lining of the bladder.
    • Stage I—Cancer cells are found in the bladder’s deeper tissues, but not in the bladder’s layer of muscle or any lymph nodes.
    • Stage II—Cancer cells have spread to the bladder’s muscles, but not in any lymph nodes.
    • Stage III—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 IV—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
    Copyright © Nucleus Medical Media, Inc.


    Bladder cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003085-pdf.pdf. Accessed June 29, 2015.

    Bladder cancer. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115106/Bladder-cancer. Updated May 6, 2016. Accessed October 6, 2016.

    Bladder cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/genitourinary-disorders/genitourinary-cancer/bladder-cancer. Updated November 2013. Accessed June 29, 2015.

    General information about bladder cancer. National Cancer Institute website. Available at: http://www.cancer.gov/types/bladder/patient/bladder-treatment-pdq. Updated May 29, 2015. Accessed June 29, 2015.

    Stages of bladder cancer. National Cancer Institute website. Available at: http://www.cancer.gov/types/bladder/patient/bladder-treatment-pdq#section/%5F109. Updated May 29, 2015. Accessed June 29, 2015.

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