Diagnosis of Bladder Cancer
Diagnosis of bladder cancer includes urological tests and imaging tests. A complete medical history is used to identify potential risk factors (e.g., smoking, exposure to dyes).
Laboratory tests may include the following:
- NMP22 BladderChek (to detect elevated levels of tumor markers in the urine)
- BTA STAT (to detect bladder tumor antigen in the urine of patients with a known history of bladder cancer; a positive test may prompt more thorough imaging and follow up)
- Urinalysis (to detect microscopic hematuriablood in the urine)
- Urine cytology (to detect cancer cells by examining cells flushed from the bladder during urination)
- Urine culture (to rule out urinary tract infection [UTI])
NMP22 BladderChek is a urine test used to detect elevated levels of a nuclear matrix protein (called NMP22). Bladder cancer increases levels of this protein in the urine, even during early stages of the disease.
Results of this test, which is noninvasive and is performed in a physician's office, are available during the patient's office visit. Studies have shown that when NMP22 BladderChek is used with cystoscopy, it may increase the clinical sensitivity of the evaluation, compared to cystoscopy and urinalysis alone.
Various imaging tests may also be performed. Intravenous pyelogram (IVP) is the standard imaging test for bladder cancer. In this procedure, a contrast agent (radiopaque dye) is administered through a vein (intravenously) and x-rays are taken as the dye moves through the urinary tract. IVP provides information about the structure and function of the kidneys, ureters, and bladder. Other imaging tests include CT scan, MRI scan, bone scan, and ultrasound.
If bladder cancer is suspected, cystoscopy and biopsy are performed. Local anesthesia is administered and a cystoscope (thin, telescope-like tube with a tiny camera attached) is inserted into the bladder through the urethra to allow the physician to detect abnormalities. In biopsy, tissue samples are taken from the lesion(s) and examined for cancer cells. If the sample is positive, the cancer is staged using the tumor, node, metastases (TNM) system.