How Bladder Cancer is Diagnosed

At Providence Saint John’s Health Center, our urologists diagnose and treat bladder cancer with the most advanced therapies available. We provide focused, personalized care with a team of specialists that will help you make informed decisions.

In order to reach a diagnosis for bladder cancer, we take a thorough medical history and conduct a physical examination to be as accurate as possible. We’ll ask questions, make note of any symptoms you may have experienced and include any other pertinent information.

The following tests may be used to diagnose bladder cancer or to find out if it has spread:

  • Urine tests: A lab checks for blood, cancer cells and other signs of disease.
  • Cystoscopy: A thin, lighted tube called a cystoscope is used to look directly into the bladder. A local anesthesia may be needed for this test because the cystoscope will be inserted into the bladder through the urethra.
  • Biopsy: A cystoscope is used to remove tissue samples and a pathologist examines them for cancer cells. In most cases, a biopsy is the only sure way to tell whether cancer is present.

For a small number of patients, bladder cancer is diagnosed during the biopsy and the doctor removes the entire area.

If the biopsy finds cancer cells, the pathologist will determine the “grade” of the tumor.

This may indicate how fast a tumor is likely to grow. Tumors with higher grades tend to grow faster and they are more likely to spread. Doctors use tumor grades along with other factors to suggest treatment options.

Bladder Cancer Staging

If you are diagnosed with bladder cancer, your doctor will determine the stage of the disease. Staging is a way of classifying cancer by how much of the disease is in the body and whether it has spread. This helps doctors plan the best way to treat the cancer.

In the case of bladder cancer, staging is used to find out whether the tumor has invaded the muscle layer, nearby tissues or more distant parts of the body.

These are the stages of bladder cancer:

  • Stage 0: Cancer cells are found only on the surface of the inner lining of the bladder. Your doctor may call this carcinoma in situ.
  • Stage I: The tumor has grown deeper into the inner lining of the bladder, but it hasn’t invaded the muscle layer.
  • Stage 2: The tumor has invaded the muscle layer.
  • Stage 3: The cancer has grown through the muscle and reached nearby tissues of the prostate, uterus, or vagina.
  • Stage 4: The tumor has invaded the wall of the pelvis or abdomen, but the cancer is not found in the lymph nodes. Or, the cancer cells have spread to at least one lymph node or to parts of the body far from the bladder, such as the liver, lungs, or bones.