Transurethral Resection Of A Bladder Tumour
If abnormalities are found in your bladder during a cystoscopy, you should be offered an operation known as TURBT. This is so any abnormal areas of tissue can be removed and tested for cancer .
TURBT is carried out under general anaesthesia.
Sometimes, a sample of the muscle wall of your bladder is also taken to check whether the cancer has spread. This may be a separate operation within 6 weeks of the first biopsy.
You should also be offered a dose of chemotherapy after the operation. This may help to prevent the bladder cancer returning, if the removed cells are found to be cancerous.
See treating bladder cancer for more information about the TURBT procedure.
Understanding Invasiveness And Grade
Two important pieces of information to know about this specific cancer are its invasiveness and grade.
Invasiveness describes how deep the cancer is in the bladder wall, which is crucial to determining treatment. If the cancer is in the inner cell layers, its noninvasive or superficial. If its grown into deeper bladder layers or spread to other organs or lymph nodes, its invasive.
Grade describes how bladder cancer cells look under a microscope. Low-grade cancers, also called well-differentiated cancers, resemble regular bladder cells. High-grade, poorly differentiated or undifferentiated cancers dont look as much like normal bladder cells, and theyre more likely to become invasive or spread to other body parts.
Invasive and high-grade cancers may be harder to treat than noninvasive and low-grade ones. They may also require a different kind of treatment.
Its also important to know the stage of cancer, or how much the cancer has spread. If the cancer has spread to other parts of the body, its called metastatic.
How Are Samples Collected
Requirements for urine sampling vary depending on the test/s being performed. Often the timing of collection is random, as dictated by the logistics of a doctor consult or access to a laboratory service. However, depending on the purpose of the test, certain urine voids of the day may be preferred. Collection of urine from all voids over a defined time period or sample collection at specific times after eating may also be necessary.
Urine samples are usually obtained by spontaneous voiding, using the clean-catch, midstream urine collection method. This involves voiding the first portion of urine into the toilet, collecting the midstream portion into a clean container, then voiding the remaining portion into the toilet. This method greatly reduces the risk of contaminants entering the sample. Less commonly, an invasive method of urine collection, such as placement of a urinary catheter, may be required.
Learn about Cxbladder’s easy-to-use in-home sampling system
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How Do You Test For Bladder Cancer
There are a few ways for a physician to test for bladder cancer. Diagnosis usually begins when a patient seeks medical attention for unusual symptoms, which can include blood in the urine or frequently feeling the need to urinate even when the bladder is empty.
After evaluating symptoms, a physician may want to order a series of tests to gain a clearer picture of the patients condition. These tests often include:
- Urinalysis to observe the levels of protein, sugar and red and white blood cells in the urine, which can signal the possibility of cancer.
- Urine cytology to look for abnormal cells in the urine under a microscope.
- Imaging such as an ultrasound, X-ray, computed tomography scan or magnetic resonance imaging to view detailed images of the bladder.
- Cystoscopy to closely examine the bladder and remove a small piece of abnormal tissue for biopsy, if necessary, using a thin instrument with a lens. This minimally invasive procedure is known as transurethral resection of bladder tumor .
Undergoing A Cystoscopy And Biopsy
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Ask Your Doctor For A Referral To A Urologist
For women diagnosed with a UTI, Dr. Donat has this advice: Make sure your doctor sends a urine culture for testing, she says. If you did have a culture, make sure it came back positive to confirm that you actually have an infection. If the culture was negative or your bladder symptoms continue despite treatment, dont be afraid to ask your doctor for a referral to a urologist to get a formal evaluation.
Tests can sometimes distinguish the bleeding associated with bladder cancer from postmenopausal uterine bleeding, but the results are not always clear-cut. Your gynecologist can send a catheterized urine sample for testing to determine the source of the blood and to evaluate for gynecologic causes of the bleeding, Dr. Donat explains. If your gynecologic exam fails to identify the source of the bleeding or is inconclusive, or if your irritative bladder symptoms persist, you should also seek out the expertise of a urologist.
Hematuria may originate in the bladder or the kidneys, says Dr. Donat, so a urologist needs to check both. This is best done with a special CT scan of the urinary tract called a CT urogram and by looking in the bladder with a lighted telescope called a cystoscope. This procedure, called a cystoscopy, is usually done in an office in just a few minutes and does not require anesthesia, says Dr. Donat. A urine test called a cytology may also be sent to check for cancer cells in the urine.
Causes Of Bladder Cancer
There are certain things that can affect the chances of developing bladder cancer. These are called risk factors.
The main risk factor is age. Bladder cancer is more common in people over the age of 60. It is rare in people under the age of 40. Another risk factor is smoking. Smoking may cause about 4 in 10 bladder cancers.
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How Bladder Cancer Is Diagnosed
A thorough and accurate diagnosis is the first step in developing a bladder cancer treatment plan. At Cancer Treatment Centers of America® , our bladder cancer experts use a variety of tests and tools for diagnosing this disease and developing a customized treatment strategy for each patient. Throughout treatment, imaging and laboratory tests are used to track the size of the tumor, monitor the response to treatment. and modify the treatment plan when needed.
Doctors may suspect bladder cancer if a patient has symptoms such as blood in the urine or pain when urinatingor if lab tests done for another reason show abnormal results.
Surgery For Bladder Cancer
Surgery is done for most bladder cancers. The type you have depends on the stage of the cancer.
Removing the tumor from the inside bladder is the most common surgery for early bladder cancer. This can be done during a cystoscopy. A a cystoscope with a looped wire on the end is used to remove the tumor.
When the cancer is more invasive, the cancer is removed along with part of the bladder or the entire bladder.
If only part of the bladder is removed, you’ll still be able to hold and release urine as normal, though in smaller amounts. If the entire bladder is removed, you’ll need another way to store and pass urine. Your doctor can explain the options for this.
Side effects of surgery
Any type of surgery can have some risks and side effects. For instance, removing the bladder not only changes how your body passes urine, but it can also cause sexual side effects. If you have these or any other problems, let your doctors know. There are ways to help deal with many side effects.
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What Will Happen After Treatment
You’ll be glad when treatment is over. But its hard not to worry about cancer coming back. Even when cancer never comes back, people still worry about this. For years after treatment ends, you will see your cancer doctor. Be sure to go to all of your follow-up visits. People who have had bladder cancer are at high risk of having a second bladder cancer.
If you have no signs of cancer, most experts advise seeing with your doctor every 3 to 6 months. These visits might include urine tests, blood work, and other tests. If you still have your bladder, you will need regular exams of your bladder, too. The time between doctor visits may be longer after a few years if no new cancers are seen.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us or talk to your doctor to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life making healthy choices and feeling as well as you can.
Questions To Ask The Doctor
- What treatment do you think is best for me?
- Whats the goal of this treatment? Do you think it could cure the cancer?
- Will treatment include surgery? If so, who will do the surgery?
- What will the surgery be like?
- How will I pee after surgery?
- Will I have other types of treatment, too?
- Whats the goal of these treatments?
- What side effects could I have from these treatments?
- Is there a clinical trial that might be right for me?
- What about treatments like special vitamins or diets that friends tell me about? How will I know if they are safe?
- What should I do to be ready for treatment?
- Is there anything I can do to help the treatment work better?
- Whats the next step?
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Bladder And Other Urothelial Cancers Screening Patient Version
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Screening is looking for cancer before a person has any symptoms. This can help findcancer at an early stage. When abnormaltissue or cancer is found early, it maybe easier to treat. By the time symptoms appear, cancer may have begunto spread.
Scientists are trying to better understand whichpeople are more likely to get certain types of cancer. They also study the thingswe do and the things around us to see if they cause cancer. Thisinformation helps doctors recommend who should be screened for cancer, whichscreening tests should be used, and how often the tests should be done.
It is important to remember that your doctor does not necessarilythink you have cancer if he or she suggests a screening test. Screeningtests are given when you have no cancer symptoms.
If a screening test result is abnormal, you may need to have more tests done to find out if you have cancer. These are called diagnostic tests.
Urine Lab Tests To Rule Out Bladder Cancer
If the healthcare provider thinks that bladder cancer may be the cause of the symptoms, the patient may be asked to provide a urine sample for analysis in the laboratory. Several types of urine lab tests may be used to help make a diagnosis of bladder cancer, including:
- Urinalysis testing
- Urine tests for tumor markers
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Advanced Diagnostics With Blue Light Flexible Cystoscopy
Blue light cystoscopy is a newer type of flexible cystoscopy that is available through the University of Michigan Rogel Cancer Center for both diagnosis and treatment. Using the blue light technique versus a white light has been shown to improve diagnosis accuracy, as well as delay tumor recurrence.
Blue light cystoscopy uses a special chemical that is absorbed by tumors. This makes tumor cells appear as bright blue tissue in the bladder. As a result, a small tumor that is difficult to see becomes much more obvious. Other benefits of blue light cystoscopy include:
- Slower tumor recurrence: A study found bladder tumor recurrence took seven months longer with the blue light technique, allowing patients to avoid invasive procedures and potentially reducing the frequency of bladder checks.
- Better high-risk identification: The blue light technology is able to identify high-risk tumors in addition to low-risk tumors. Early detection of this type of tumor means patients can begin treatment quicker, when theres the greatest chance for a cure.
How To Diagnose Bladder Cancer
This article was co-authored by Robert Dhir, MD. Dr. Robert Dhir is a board certified Urologist, Urological Surgeon, and the Founder of HTX Urology in Houston, Texas. With over 10 years of experience, Dr. Dhirs expertise includes minimally-invasive treatments for enlarged prostate , kidney stone disease, surgical management of urological cancers, and mens health . His practice has been named a Center of Excellence for the UroLift procedure, and is a pioneer in non-surgical procedures for ED using his patented Wave Therapy. He earned his undergraduate and medical degrees from Georgetown University and was awarded honors in pre-medical studies, urology, orthopedics, and ophthalmology. Dr. Dhir served as chief resident during his urological surgical residency at University of Texas at Houston / MD Anderson Cancer Center in addition to completing his internship in general surgery. Dr. Dhir was voted Top Doctor in Urology for 2018 to 2019, one of the top three Best Rated Urologists in 2019 & 2020 for Houston Texas, and Texas Monthly has named him to the 2019 & 2020 Texas Super Doctors Rising Stars list.There are 24 references cited in this article, which can be found at the bottom of the page. This article has been viewed 14,671 times.
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Urine Tumor Marker Tests
Different urine tests look for specific substances made by bladder cancer cells. One or more of these tests may be used along with urine cytology to help see if you have bladder cancer. These include the tests called NMP22® , BTA Stat®, Immunocyt® , and UroVysion®, which are discussed in Can Bladder Cancer Be Found Early?
Some doctors find these urine tests useful in looking for bladder cancers, but they may not help in all cases. Most doctors feel that cystoscopy is still the best way to find bladder cancer.
Some of these tests are more helpful for finding bladder cancer that has come back in someone who has already had it, rather than first diagnosing it.
If Youve Been Diagnosed With Bladder Cancer Seek Out A Team Of Experts
Most people require a combination of therapies to treat bladder cancer successfully. The best plan is different for each person, says Dr. Donat. This customized treatment approach requires the expertise of multiple specialists.
At MSK, most people with bladder cancer meet with a urologic surgeon and medical oncologist as well as a radiation oncologist when needed. This close collaboration helps ensure that MSK patients receive the best care possible. The benefit of MSK is that we bring world-class expertise in each type of treatment to bear for every individual we care for, and we are on the forefront of developing new treatments, says Dr. Donat.
Its also important to know that expert bladder cancer care means not only lifesaving treatments but preserving your quality of life and, if possible, your bladder. We want all of our patients female and male to feel their best after bladder cancer surgery, says Dr. Donat. As surgeons, we do that through a variety of techniques, including minimally invasive approaches and other specialized techniques to preserve or reconstruct the bladder and to maintain sexual function.
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Who Might Need A Cystoscopy
Your healthcare provider may recommend a cystoscopy if you experience:
- Bladder control issues, such as urinary retention or incontinence .
Treatments using cystoscopy
Your doctor may also use a cystoscope to:
- Get urine samples from ureters .
- Inject dye for an X-ray procedure that tracks urine flow.
- Inject medication to stop urine leakage.
- Remove a ureteral stent placed during an earlier procedure.
- Remove bladder stones, abnormal tissue, polyps or tumors.
- Take small pieces of bladder or urethral tissue to biopsy .
- Treat urethral strictures or fistulas .
What To Do After A Bladder Cancer Diagnosis
Receiving a bladder cancer diagnosis can be overwhelming. At Moffitt Cancer Center, were here to help. Our Urologic Oncology Program includes highly experienced physicians from multiple specialties who focus solely on diagnosing and treating bladder cancer. Whether you need diagnostic testing, a second opinion or comprehensive treatment and supportive care, our team can provide all the services you need under one roof. Moffitt also stands at the forefront of cancer research, offering a robust clinical trial program that allows eligible patients to receive the latest breakthroughs in bladder cancer treatment before they are made widely available.
Contact Moffitt at or submit a new patient registration form online to consult with a Moffitt oncologist without a referral.
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