Your Urologist will ask you about your symptoms and general health, and arrange the following tests.
Blood and urine tests
Cystoscopy – a specialist nurse or doctor uses a cystoscope (a thin tube with a camera and light on the end) to look at the inside of your bladder.
Ultrasound scan – this uses sound waves to look at internal organs
CT scan (computerised tomography) – a series of X-rays that builds up a three-dimensional picture of the inside of the body.
Intravenous urogram (IVU) – a dye is injected into the bloodstream and passes through the urinary system to show if there are any problems.
MRI scan (magnetic resonance imaging) – uses magnetic fields to build up a series of cross-sectional pictures of the body.
Bone scan – a scan of the whole body to show any abnormal areas of bone.
Grading and staging of bladder tumours
- Grade 1 tumours are less aggressive
- Grade 2 tumours are moderately aggressive
- Grade 3 tumours are most aggressive and most likely to spread.
The extent of the tumour is called its stage. Treatment option depends on the stage and the grade of the tumour.
- Carcinoma in situ – bladder cancer cells are completely contained on the inner surface of the bladder lining.
- Stage Ta – affects the epithelium. In most superficial cancer stage, the tumour is confined to the inner layer of transitional cells. Provided the grade is 1-2, this is very unlikely to progress.
- Stage T1 – the tumour has started to invade the inner layer of muscle of the bladder (lamina propria), but has not reached the detrusor muscle.
- Stage T2 – the tumour has spread into the muscle layers of the bladder wall.
- Stage T3 – the tumour has spread through the deeper muscle layers into the surrounding fat.
- Stage T4 – the tumour has spread beyond the bladder into areas around the bladder, e.g. prostate, vagina, bowel and or other parts of the body.
After treatment, it is normal to have regular follow-up cystoscopies, every 3 months to check that the tumour has not returned.
Sometimes these checks can be performed using flexible cystoscopies every 6 or 12 months to ensure that if the tumour does return, it is removed as early as possible.