At Dana-Farber Brigham 天美传媒, our team uses a comprehensive diagnostic process to accurately diagnose bladder cancer. It begins with a thorough medical history and physical exam to evaluate any symptoms and identify potential risk factors. If bladder cancer is suspected, our team may recommend one or more diagnostic tests, such as a urine test, blood test, or imaging tests like a CT scan or MRI. These tests can help our team identify any abnormalities or changes in the bladder or surrounding tissues that may indicate the presence of cancer.
Tests to Diagnose Bladder Cancer
In some cases, our team may recommend some of the following diagnostic tests:
Blood and urine tests
- Urine cytology: A urine sample is taken from the patient and examined under a microscope for evidence of bladder cancer cells.
- Imaging tests: such as CT Urogram, (a CT-scan focused on the urinary tract), Magnetic Resonance Imaging (MRI), CT Positron Emission Tomography (CT/PET) or Bone Scan.
- Cystoscopy: this procedure involves inserting a small scope through the urethra to visually examine the urethra and bladder. Biopsies of any suspicious areas can be taken during a cystoscopy procedure. A cystoscopy can be performed in a urologist’s office or in an operating room.
- Blue Light Cystoscopy with Cysview: This cutting-edge procedure involves using a cystoscope equipped with both white and blue light. Prior to the examination, an optical imaging agent is introduced into the bladder, causing cancer cells to emit a vivid fluorescent pink glow under the blue light. This stark contrast enables doctors to easily identify cancerous cells, enhancing visualization and improving the detection of non-muscle invasive bladder cancer lesions.
Learn more about being with bladder cancer.
Stages and Grades of Bladder Cancer
Staging is a way to describe where cancer is in the body, whether it has spread, and how it might be affecting other parts of the body. Knowing the stage helps the doctor suggest the best treatment and predict the chance of recovery.
- Non-muscle invasive bladder cancer is a type of cancer where the tumor stays within the bladder’s inner lining and has not invaded the muscular wall of the bladder. Although non-muscle invasive bladder cancers are non-life-threatening, they require treatment and life-long surveillance. This is considered early stage and represents two-thirds of all bladder cancers diagnoses.
- Muscle-invasive bladder cancer is an aggressive form of the disease that requires immediate treatment. Treatment may include a combination of , radiation therapy, or surgery.
- Metastatic bladder cancer is a bladder cancer that has spread from the bladder to other parts of the body. Treatments for metastatic bladder cancer often include chemotherapy and/or immunotherapy.
Different types of cancer have different stage descriptions. Bladder cancer stages include:
- Stage 0: Also known as "in situ," meaning "in its original place" in Latin, stage 0 indicates noninvasive bladder cancer, where cancer cells are found in the tissue lining the inside of the bladder but haven't invaded into the wall of the bladder. Stage 0 has two sub-stages:
- Stage 0a, also called noninvasive papillary carcinoma, may appear as long, thin growths extending into the bladder lumen. It can be low grade or high grade based on cell abnormalities observed under a microscope.
- Stage 0is, also known as carcinoma in situ (CIS), a flat tumor on the tissue lining the inside of the bladder and is always high grade (see bladder cancer grade).
- Stage I: cancer is found in the bladder's inner lining but has not infiltrated the muscular bladder wall.
- Stage II: cancer has progressed to invade the muscular wall of the bladder but is still contained within the bladder.
- Stage III: cancer cells have spread through the bladder wall into surrounding tissue, potentially affecting nearby structures like the prostate in men or the uterus or vagina in women.
- Stage IV: cancer cells have spread to the wall of the abdomen or pelvis and may have reached lymph nodes or distant organs like bones, liver, or lungs. This signifies metastatic bladder cancer, indicating the spread of cancer beyond the bladder.
Bladder Cancer Grades
Cancer grade tells us how abnormal the bladder cancer cells look under a microscope and how fast they might grow and spread. The grade, along with other things like the stage, helps the doctor plan treatment and sometimes estimate the prognosis.
- Low-Grade: These cells look more like normal cells and usually grow and spread more slowly than high-grade cancer cells.
- High-Grade: This type tends to grow and spread faster than low-grade cancer. High-grade cancers may need more urgent or more intense treatment.
