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Learn: Diagnosis

The tests

If you visit your doctor/consultant and they are concerned you could have bladder cancer, they will start the process of a series of tests to confirm or eliminate bladder cancer as a diagnosis. The most common tests are:

  • a wee test
  • an ultrasound scan
  • cystoscopy, where a flexible tube with a small camera is inserted through your urethra into the bladder so that they can have a clear look at the bladder lining. Sometimes a biopsy is carried out at the same time
  • CT or MRI scan

You may be asked to supply a sample of your wee, or you might be sent directly to a hospital for a series of further tests, depending on how certain your doctor is of your diagnosis. 

All these tests?

All these tests are important to make sure you either have bladder cancer or not. Many of the symptoms of bladder cancer are exactly the same as those experienced with a simple UTI (urinary tract infection) so it is important to rule out the simple things first. 

The wee test

The wee test

One of the first tests that you could experience is a simple test on your wee. Known as a ‘urinary cystography’, this is a relatively simple test to see if you have any cancer cells in your wee. Unfortunately, this is not a 100% accurate test, as it can result in a positive result for cancer cells when they are not actually there, and sometimes even miss cancer cells that are present. This is why this test is used to help to diagnose bladder cancer, but is not used to provide a definitive diagnosis in itself. However, it is a good starting point and if the test is inconclusive or if bladder cancer is suspected, you are likely to be referred to a urologist for further testing. 

The ultrasound scan

The ultrasound scan 

This is the same kind of procedure they use to monitor pregnancies. The ultrasound scan is a good way of seeing into the internal organs of your body and the radiologist that will carry out your scan will be able to see if there are any signs of something abnormal going on in your bladder.

It is usually possible at this stage to see whether or not you have bladder cancer. However, some cases are more difficult to detect and even if there is an obvious growth in your bladder, further detailed tests will be needed. The next test, a cystoscopy, is the most important test for bladder cancer. 

Cystoscopy

Cystoscopy – what is it? 

A cystoscopy is a procedure that allows your urologist to have a look inside your bladder to see if there are any signs of bladder cancer. The cystoscopy is carried out with a cystoscope, an instrument which is a thin fibreoptic tube that has a light and a camera at one end. It is inserted into your urethra and is moved up into your bladder so that your urologist can have a good clear look. The images are shown on a large screen for the urologist to review and quite often you will also be able to see the same images as the investigations proceed. Some people would rather not look at the imagery on the screen, so don’t be afraid to tell them that.

This may sound a very strange and embarrassing procedure, but it does sound a lot worse than it really is. Honestly. They will use a local anaesthetic gel or spray to numb your urethra. It’s normal to give a little “gulp’ when they start to insert it, but after those first few seconds you realise that there isn’t too much to worry about. For this bladder inspection it is most likely that they will use a flexible cystoscope, but there are ridged ones that are used for more involved treatments such as collecting a tissue sample or even removing cancer growths themselves. When they do use a rigid cystoscope it is almost always carried out under a general anaesthetic or with an epidural that will completely numb the pain.

A typical cystoscopy examination to see if there are any signs of bladder cancer is usually carried out as an outpatient procedure, so you will be able to go home the same day. Side effects are normally very slight and limited to muscle pain, a little nausea and possibly some blood in the urine. There is a small risk of getting a UTI after the procedure, and you should see your GP if you experience the symptoms of an infection, such as a high temperature.

It is very rare that there are any more serious side effects, but if you do have any trouble passing urine for more than 8 hours you should contact your GP or the hospital where you had the procedure carried out immediately. 

CT & MRI scans

CT & MRI scans 

Occasionally, your medical team might get you to have a CT or MRI Scan to help with their diagnosis. This will just help them get a better idea of your particular diagnosis if there is any doubt. 

These scans are painless and safe but you will need to let the hospital know if you have any allergies or kidney problems, or if you're taking medication for diabetes, because special arrangements may need to be made. You should also let the hospital know if you're pregnant. CT scans aren't usually recommended for pregnant women unless it's an emergency, as there's a small chance the X-rays could harm your baby.

Not everyone can have an MRI scan. For example, they are not always possible for people who have certain types of implants fitted, such as a pacemaker. 

What happens after these tests?

You wait for the results. It can take several weeks for some diagnoses to be made. Sometimes, it will be obvious straight away and your medical team will talk to you before you even go home. Whether you have to wait just half an hour or two weeks, trust us, it will seem like forever. Hang on in there – this is all part of you getting the best treatment for your cancer as you move forward.

If, after the tests, you receive a confirmed bladder cancer diagnosis, take a look at our Just Diagnosed page to find out more about what happens next. 

Can we help?

We’ve done everything we can to make all the information on this site as accurate as possible. Whilst we have had support from a small team of medical professionals advisors to review the general medical content of this site, please remember, that only YOUR medical team can give YOU specific advice about YOUR symptoms or illness. We encourage you to discuss any potential options with them.