How is bladder cancer diagnosed?

If a doctor suspects bladder cancer based on your symptoms, they will start you on a series of tests to confirm or eliminate bladder cancer as a diagnosis.

Many doctors use more than one test.

These tests are split into non-invasive which means that nothing is inserted into the body, and invasive, which means that small cameras or instruments are inserted into the body in order to carry out that test.

The most common non-invasive tests are:

  • Urine test
    • Cytology – a microscope is used to look for cancer cells in the urine. Cytology does find some cancers but it’s a test that is often not reliable enough on its own, so will be done in conjunction with another
    • Biomarker tests such as ADXBLADDER – a sample of urine is tested by a laboratory to see whether biomarkers are present. Biomarkers are signals that can tell doctors whether something abnormal is happening at a cellular level in the body and are a reliable way of ruling out cancer

Currently in the UK, doctors will routinely give people they suspect of having the disease a cytology test. Biomarker tests are not routinely carried out but they are becoming more widely used to give a second opinion and are much more accurate than cytology. It’s worth asking a doctor about biomarker tests when diagnostic tests are being carried out.

  • Ultrasound scan – this uses sound-waves to create a picture of the bladder. It is used to show if cancer is present and how large it is. But an ultrasound can’t always find small tumours, so a doctor will probably conduct another test as well
  • CT scan – this is a test that uses X-rays and a computer to create detailed pictures of the inside of the body and can tell a doctor where the tumour is or if it has spread
  • MRI scan – this scan creates pictures of the inside of the body using magnetism and radio waves, producing pictures from angles all around the body and showing up soft tissues such as the walls of the bladder

Invasive tests:

  • Cystoscopy – this is where a thin, flexible tube with a small camera is inserted through the urethra into the bladder so that a doctor can have a clear look at the bladder lining. A local anaesthetic is given but the procedure can be uncomfortable and sometimes can result in a urinary tract infection (UTI)
  • Biopsy – this is a medical procedure that involves taking a small sample of body tissue which can then be examined under a microscope