Bladder Cancer

Diagnosis

Early, accurate bladder cancer diagnosis is essential to effective treatment and can greatly increase your treatment options as well as your chance for success. Mayo Clinic uses a wide variety of screening and diagnostic services in bladder cancer diagnosis, including urine tests, specialized kidney X-rays, and cystoscopies.

Our bladder cancer care team members understand the anxiety associated with cancer testing, and are committed to providing you a complete, accurate and prompt diagnosis. At Mayo, most diagnostic tests for bladder cancer are completed within 24 to 48 hours, so you can consult with your doctor about treatment options as soon as possible. Your diagnosis may involve the following tests:

Urine-Based Marker Tests

Mayo Clinic researchers continue to explore the area of urine-based marker tests, which are generally non-invasive, fairly reliable for detecting low-grade bladder cancer and are useful for monitoring possible recurrence. These tests are designed to identify key urine indicators that suggest bladder cancer recurrence.

Cystoscopy

This procedure involves the insertion of a narrow flexible tube (cystoscope) through the channel that carries urine out of the body (urethra). At the end of the cystoscope, a special lens and fiber-optic lighting system allows the doctor to visually inspect the urethra and bladder. The cystoscope also allows the doctor to remove a small tissue sample for laboratory analysis.

Advanced Imaging Techniques

A positron emission tomography (PET) scan can help your physician locate cancerous tissue. A PET scan relies on color intensity within tissues and organs. Colors indicate overall chemical activity and can reveal possible areas of disease or abnormalities, including cancer.

Computed tomography urography (CTU) and magnetic resonance urography (MRU) are proven technologies for urinary tract evaluation and enable your physician to bring a more precise set of diagnostic tools to assess your condition.

CTU allows your physician to view cross sections of the body and see far more anatomical detail than is possible through regular X-rays. Eventually, by combining the diagnostic tools of intravenous urography and CT, CTU may replace many intravenous urograms for evaluating patients with blood in the urine (hematuria) and other urinary or reproductive system conditions.

MRU provides an alternative imaging technique for children and pregnant women (for whom intravenous urography and CTU may not be appropriate) as well as for patients with contradictory results from traditional diagnostic tests. MRU is not as widely used as CTU, but new hardware and technological innovations improving spatial resolution and efficiency have led to increased interest in MRU techniques.

FISH Test

Mayo Clinic researchers pioneered the fluorescence in situ hybridization (FISH) test, which relies on a mix of fluorescent-labeled probes to determine whether urinary cells harbor abnormalities indicating malignant cancer. FISH testing has proven more reliable than standard urine cytology when diagnosing bladder cancer and can detect cancer recurrence three to six months earlier than standard cytology. The FISH method is particularly useful in detecting high grade cancers that pose the most immediate risk of progressing to incurable bladder cancer strains.