How is it Diagnosed?
Bladder cancer diagnosis begins with a clinical history and symptom evaluation,
especially in patients presenting with painless hematuria (blood in urine), the most
common early sign. Other symptoms include increased frequency, urgency, and dysuria
(painful urination).
Urinalysis confirms the presence of blood, and urine cytology can detect cancerous
cells shed into urine, though its sensitivity is higher for high-grade tumors.
The gold standard for diagnosis is cystoscopy—a procedure in which a thin, lighted
scope is inserted through the urethra to directly visualize the bladder lining. If
suspicious lesions are seen, a biopsy is performed for histopathological confirmation.
Imaging studies play a crucial role in staging and detecting tumor spread. A CT urogram
or MRI provides detailed cross-sectional images of the urinary tract and surrounding
tissues. Intravenous pyelogram (IVP) may also be used, though less commonly.
Urine-based molecular tests (e.g., NMP22, UroVysion FISH) may aid in diagnosis and
surveillance, especially in high-risk patients.
Transurethral resection of bladder tumor (TURBT) is both a diagnostic and initial
therapeutic procedure that allows tissue sampling and determines the depth of
invasion.
Further staging may involve chest imaging, bone scans, or PET-CT in advanced disease
to evaluate metastasis. Accurate diagnosis and staging guide treatment strategies such
as surgery, intravesical therapy, chemotherapy, or immunotherapy.