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How Does My Doctor Know I Have Bladder Cancer?

If you're having bladder-cancer-like symptoms, your doctor will want to know why. Your doctor is likely to ask you questions about these things:

  • Your medical history, including whether you have taken the chemotherapy drugs cyclophosphamide or ifosfamide or have had radiation treatment in the pelvic area

  • Your smoking history

  • Your history of exposure to certain types of chemicals in the workplace

  • Your history of bladder infections or other things that may cause physical trauma to the bladder. This may include a parasitic infection in the bladder, called schistosomiasis, which is more common in less developed countries.

  • Your family history of cancer

  • Other risk factors that may cause chronic irritation to the bladder

Your doctor will recommend the tests appropriate to your condition. If you have questions about these tests, be certain to ask your doctor before agreeing to have them performed. All of your concerns should be addressed before the procedure begins. 

In addition to asking you questions, your doctor may also do 1 or all of these tests:

  • Urinalysis and urine culture. The goal of this test is to look for signs of infection or other problems that may be causing your symptoms. For the test, your urine is checked in a lab for blood, certain chemical levels, and signs of infection. The urine is cultured to see if organisms, such as bacteria, grow. It usually takes a few days for the test results to come back. A test that shows an infection may explain the symptoms.

  • Urine cytology test. For this test, your urine is looked at in a lab under a microscope. The cells are examined to see if any of them are cancerous or precancerous.

  • NMP22 test. For this test, your doctor checks your urine for the level of nuclear matrix proteins. These are found in normal and cancerous cells, but people with bladder cancer usually have higher levels.

Cystoscope

  • Cystoscopy. This procedure lets your doctor examine the inside of your bladder and is the best test for diagnosis of bladder cancer. Your doctor slides a thin tube with an attached tiny camera lens and light, called a cystoscope, through your urethra into your bladder. If your doctor sees anything that looks like cancer, he or she might remove a small sample of the tissue for examination. Your doctor may decide to take a urine sample with a bladder wash during a cystoscopy. This is when a salt water solution is placed into the bladder through a tube inserted in the urethra. The solution is then removed and examined under a microscope.

The results of these exams may show that you don't have cancer. Or the results may require additional tests. For example, your doctor may need to remove cells and tissue from a suspicious area found in your bladder. This is called a biopsy. If the area looked suspicious during the cystoscopy, but the biopsy came back negative for cancer, the biopsy may need to be repeated.