To find out whether bladder cancer may be the cause of your urinary symptoms, your doctor will:

• Do a physical exam. This may include a rectal exam, a prostate exam for men, or a pelvic exam for women.
• Ask questions about your medical history, including:
  • Your smoking history.
  • Your possible exposure to cancer-causing chemicals.
  • Your family history of cancer.
• Order a urine test and urine culture to check for the presence of blood, infection, and other abnormal cells.

Cystoscopy

You will have a cystoscopy, a test that allows your doctor to look at your bladder with a thin, lighted tube. The doctor can use the same tube to take small tissue samples (biopsies) of any abnormal areas. The samples will be looked at under a microscope to find out whether cancer cells are present and what the cells look like.

Tests to determine stage and grade

Bladder cancer is classified by stage and grade. The stage is determined by the cancer growth in the bladder wall and how far it has spread to nearby tissues and other organs, such as the lungs, the liver, or the bones. The grade of bladder cancer is determined by how the cancer cells look in comparison with normal bladder cells.

Your doctor finds out the stage and grade of your bladder cancer by gathering information from several tests, including:

• Biopsies from the cystoscopy.
• Computed tomography (CT) scan or magnetic resonance imaging (MRI). These help find out if the cancer has spread to lymph nodes, the lungs, the liver, or other abdominal organs.
• Chest X-ray. This finds out if the cancer has spread to the lungs.
• Bone scan. This finds out if the cancer has spread to the bones.

The stage and grade of your cancer are important in choosing the right treatments.

Other tests

Other diagnostic tests that may be done include:

• A complete blood count (CBC) to find out if you have anemia.
• A chemistry screen to evaluate kidney, liver, and bone functions.
• An intravenous pyelogram or computed tomography (CT urogram) to look for a mass near the kidneys, ureters, or bladder.

Early detection of returning cancer

Bladder cancer often comes back, so it's important to have regular checkups. Then, if the cancer does come back, you have a better chance of finding it early enough for successful treatment.