Do you also have blood in your urine? Or do you feel like you have to urinate frequently? Seeing these, you may be very scared, thinking, 'Oh, do I have bladder cancer too?' But don't be afraid. Not all symptoms mean cancer. So, how exactly does a doctor find out if you have this condition? What tests are done for this? We will talk about it in detail today, in a way that you can understand.
What does the doctor do first?
So when you go to the doctor with these symptoms, the first thing he or she will do is talk to you. He or she will ask about your overall health, any other medical conditions you have, the medications you are taking, and whether anyone in your family has had bladder cancer before . This will give the doctor a good idea of your medical history.
Next, your doctor will do a physical exam. At this time, a pelvic exam may be performed for women and a digital rectal exam (DRE) for men. This may seem a little uncomfortable, but it is a very important test. It can sometimes give a rough idea of whether a tumor in the bladder is palpable, how large it is, and whether it has spread.
If the doctor has any further doubts after these initial tests, he may refer you to a specialist, a urologist, who will then conduct various tests.
What can be found in urine tests?
A urine sample can reveal a lot of things. This is usually the first test done.
| Test Name | What do you see in this? |
|---|---|
| Urinalysis | Simply put, this is a full report. It checks your urine for things like blood, sugar, and protein. It can detect even small amounts of blood that are too small to be seen with the naked eye. |
| Urine Cytology | What you do here is examine your urine sample under a microscope to see if there are any cancer cells in it. |
| Urine Culture | Your urine sample will be left to grow in the lab for a few days to look for germs that can cause infections. This will tell you if you have a urinary tract infection. |
| Urine Tumor Marker Tests | Bladder cancer cells sometimes release specific substances into the urine. This test looks for these substances. |
Cystoscopy (examination of the bladder with a camera)
This name may sound a little scary, but this is the main and most accurate way to detect bladder cancer.
Imagine a very fine, thin tube. It has a small camera and a light at the end. The doctor carefully inserts this tube (called a cystoscope) into your urethra and into your bladder. Then, through the tube, he fills the bladder with saline water, causing it to swell up a little. Then, the camera can see the inside of your bladder very clearly.
Before this is done, your urethra and bladder are numbed. Sometimes, if it's done in an operating room, you're completely anesthetized, meaning you're unconscious. So you don't feel anything.
Suspicious area removal and testing (TURBT)
If the doctor sees a suspicious-looking area, such as a tumor, while looking through the camera, he will immediately take a small piece of it and send it for testing. This is what we call a biopsy .
Sometimes, the doctor will perform a procedure called TURBT (Transurethral Resection of Bladder Tumor) . In this, while the camera is in place, a special instrument is used to cut out and remove the suspicious tumor almost completely. At the same time, a part of the bladder muscle around the tumor is also removed. Then, these pieces are sent to the lab to see exactly whether it is cancer and, if so, how deep it has spread.
Scans and X-rays (Imaging Tests)
If cancer is confirmed, different types of scans are used to see how far it has spread and whether it has spread to other organs. These take pictures of things inside your body.
| Test Name | What do you do and learn from this? |
|---|---|
| Intravenous Pyelogram (IVP) | This is a type of X-ray. A special dye is injected into your vein. As this dye passes through your kidneys and down your urinary tract, the X-ray shows things like tumors clearly. |
| CT Scan | This can take a 3D image of your kidneys, bladder, and urethra. It can also clearly see tumors in the urinary tract and lymph nodes to see if the cancer has spread. |
| MRI Scan | Magnetic resonance imaging (MRI) uses magnetic waves to take pictures of the inside of the body. This can also help to better assess the condition of the urinary tract and surrounding tissues. |
| Ultrasound Scan | It uses sound waves to take pictures of the bladder. This can measure things like the size of a tumor in the bladder. |
| Chest X-ray and Bone Scan | Bladder cancer can sometimes spread to the lungs or bones. This X-ray and bone scan are done to confirm whether this has happened. |
It is by combining the information from all these tests that the doctor reaches a final conclusion about your condition and decides which treatment method is most suitable for you.
Take-Home Message
- If you have a symptom like blood in your urine , never ignore it. Don't assume it's normal. See a doctor as soon as possible.
- The tests (such as cystoscopy and biopsy) that are performed when bladder cancer is suspected can be a bit scary. However, they are performed in a way that you will not feel any pain or discomfort, and if necessary, they are performed under anesthesia.
- Every test is designed to find out exactly what the problem is. So don't be afraid to undergo the tests your doctor recommends. It's for your own good.
- Talk openly with your doctor about any questions, fears, or concerns you may have. Don't worry about "what the doctor will think if I ask you this." It is your right to be fully informed about your condition.
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