The diagnosis of bladder cancer, like other cancers, is dependent mostly on physical examinations and an eventual biopsy.  There are a number of diagnostic tools that doctors use for bladder cancer diagnosis, including radiology and cystoscopy.  If certain symptoms are present, an individual is recommended to see a doctor for future diagnostic tests.

Clinical Examination

When a doctor is searching for a bladder cancer diagnosis, he or she will always compile a complete medical history to determine the risk factors and symptoms of a patient.  For example, if a patient has a parent who has suffered from a bladder cancer in the past, he or she is at higher risk for bladder cancer.  After taking a medical history, a doctor will conduct a physical examination for bladder cancer.  The doctor will feel the abdomen and pelvis for tumors, including a possible rectal or vaginal examination.

Urinalysis

The urine of a patient is examined under a microscope to see whether it contains any cancerous cells.  This is called urine cytology.  The doctor will also take a urine culture, where a sample of urine is put into a dish to allow any bacteria to grow.  These tests are done to ensure that the urine is not infected.  Urine tests are also capable to affirming symptoms, such as blood in the urine.

Imaging Tests

Bladder cancer diagnosis can be found through the use of imaging tests.  These tests may show whether the cancer has spread to other areas, as well as the need (or lack thereof) of a possible biopsy.

Intravenous pyelogram (IVP)

An intravenous pyelogram is an x-ray test that uses dye to examine the kidneys, ureters, and bladder.  The dye helps to outline these organs and helps to find tumors in the urinary tract.  It also can help to diagnose symptoms such as blood in the urine or pain in the side or back.  This particular type of examination is used by radiologists to detect other problems in the urinary tract, including kidney stones or enlarged prostate.

Intravenous pyelograms is minimally invasive and can provide enough information to suggest treatment with medication, avoiding more invasive surgical procedures.  It also does not leave radiation on the body and has little to no side effects.

Retrograde pyelography

Like IVP, retrograde pyelography is used to find tumors in the urinary tract.  The procedure involves a tube being placed into the bladder where a dye is then injected to highlight the bladder, kidneys, and ureters on x-rays.  It is often performed to identify defects, and requires cystoscopy to place the tube.

Computer Tomography

Also known as CT scanning, this procedure produces a detailed x-ray of the body with cross-sections that allow the radiologist to see extreme details of the anatomy usually unseen.   A CT scan provides more detailed information about the shape, size, and location of a tumor.  It also examines the lymph nodes and assists in guiding a biopsy needle into a tumor.

Magnetic Resonance Imaging

Also known as an MRI, this test uses magnets and radio waves to take images of the body.  They are especially useful in finding signs of cancer that has spread outside of the bladder. 

Cystoscopy

A cystoscopy is a test used to look inside of the bladder and urethra using a lighted instrument named a cystoscope.  Cystoscopy allows the doctors to examine the bladder and urethra.  It also allows doctors to remove samples of tissue (biopsy) through the insertion of surgical instruments.

Biopsy

Bladder cancer diagnosis is completely dependent on a biopsy and subsequent finding of cancerous cells.  The examination of cells from the bladder is done by a pathologist, who then determines the presence and type of bladder cancer.  As each type of bladder cancer responds differently to different treatments, the correct diagnosis is imperative.  While a diagnosis can be made by examining urine cytology, this method is not as accurate as a proper biopsy.

A biopsy of the bladder is performed through the cystoscope during a cystoscopy.  The doctor will insert surgical instruments into the cystoscope, removing a small sample of the bladder tissue and analyzing it under a microscope.  After examining the cells, the pathologist determines whether the tumor is malignant as well as the type of tumor.  As such, the bladder cancer diagnosis following the biopsy will determine the proper treatment of the disease.