Bladder Cancer

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Diagnosis

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)
• Urinalysis (to detect microscopic hematuria)
• Urine cytology (to detect cancer cells by examining cells flushed from the bladder during urination)
• Urine culture (to rule out urinary tract infection)

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 used with cystoscopy, NMP22®BladderChek® may be more effective than other diagnostic tests (e.g., urine tests or cystoscopy 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.

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