Diagnosing Bladder Cancer

Support Throughout the Diagnostic Process

Our physicians, nurses and support staff are here to advise you, listen to you and calm your fears. Your physicians will explain your diagnosis and compassionately offer suggestions for treatment and care. Their job is to help you.

Also available for counsel, support and guidance are nurse coordinators, oncology social workers and a pastoral team. They’ll help you navigate through the system and provide additional assistance, including:

  • Social support
  • Spiritual guidance
  • Emotional support
  • Practical advice
  • Tips on coping

Call on them. They’re here for you.

The earlier your bladder cancer is found, the greater the likelihood you’ll make a full recovery. At Scott & White, our team of nationally recognized diagnostic radiologists and surgical urologic oncologists is highly skilled in the diagnosis of tumors of the bladder. They’re specially trained in the most up-to-date procedures and techniques available.

We have state-of-the-art diagnostic equipment to help locate your tumors with clarity and precision. And our pathology services are outstanding. Our board-certified pathologists are nationally recognized experts at identifying and classifying tumors, providing key information to your care team that will assist them in making treatment decisions.

Bladder Cancer Diagnostic Services

At Scott & White Healthcare, we use the most advanced diagnostic equipment available to detect, identify and evaluate your bladder tumors early, when cure is most likely.

If your physician suspects you may have bladder cancer, he or she may recommend one or more of the following tests.

Physical Exams and Laboratory Tests

  • Physical examination and history. Your physician will begin with a thorough physical exam and medical history.
  • Cystoscopy. In this procedure, your urologist will insert a thin tube with a lighted lens through your urethra and move it into your bladder. From there, your physician can view the inside of your bladder. If there are any abnormalities, your physician will perform a biopsy.
    • If indicated, your urologist may perform a bladder washing to look for cancer cells. A salt solution will be inserted through a tube into your bladder; once removed, the solution will be examined through a microscope for the presence of abnormalities.
    • Sometimes your urologist may perform a fluorescence cystoscopy. With this procedure, special substances called porphyrins are inserted into your bladder. Cancer cells absorb the porphyrins. When your urologist shines a blue light into your bladder, cells containing the porphyrins become fluorescent and glow, revealing the presence of any cancer.
  • Urine cytology. You may be asked to provide a sample of your urine, which will be examined under a microscope.
  • Blood and tumor marker tests. Your physician may order one or more blood tests before, during and after your treatment. Your physician may also order tumor marker tests. A tumor marker is a substance that may be found in a tumor or released from a tumor into your blood or other body fluids. A high level of a tumor marker may note the presence of a certain type of cancer.
    • Complete Blood Count
    • NMP22 — elevated levels of protein NMP22 in your urine may indicate bladder cancer
    • BTA — presence of BTA in your urine may indicate bladder cancer
    • Immunocyt™ test — checks for presence of substances in your urine that may indicate bladder cancer
    • UroVysion™ — checks for chromosomal changes that may indicate bladder cancer


A biopsy is the best way to confirm the presence of bladder cancer. Your physician may order a biopsy if cancer is suspected based on the results of other diagnostic tests. Tissue samples will be sent to the laboratory for examination by a pathologist.

  • Bladder biopsy. This procedure is usually performed during cystoscopy. Your urologist may remove several samples of bladder tissue from different parts of your bladder, as cancer often develops in multiple areas of the bladder.
  • Image-guided needle biopsy. In some cases your physician may recommend an image-guided needle biopsy. Your interventional radiologist will insert a thin needle, guided by CT scan or ultrasound, into your bladder, and will remove one or more small tissue samples.

Imaging Studies

  • Abdominal computed tomography (CT) scan
  • Abdominal ultrasound
  • Intravenous pyelogram (IVP)
  • Magnetic resonance imaging (MRI) scan
  • Positron emission tomography (PET) scan
  • Chest X-ray
  • Bone scan

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