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Friday, Apr 16th

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Home Cancer Bladder Cancer Bladder Cancer Investigation

Bladder Cancer Investigation

Bone Scans and Allied Procedures
When the physician suspects that bladder cancer has metastasized (cancerous cells have broken away from the original tumor to grow within other parts of the body), then tests such as bone scans, liver function tests, or chest X–rays may be considered. If any of these tests indicate metastasis, then further testing should be performed to confirm the diagnosis, usually by the least invasive means possible, such as fine–needle aspiration biopsy, where a fine hollow needle attached to a syringe is inserted into the suspicious mass, and the needle is pushed back and forth to free some cells. These are drawn up into the syringe and smeared on a glass slide for analysis. Bones, liver, and lungs are common sites of cancer metastasis.

Cystoscopy (also known as cysto–urethroscopy) is a procedure that lets the physician see the inside of the bladder, bladder neck, and urethra. Usually performed in the doctor’s office or outpatient facility, cystoscopy is perhaps the most powerful diagnostic tool for the diagnosis of bladder cancer.

A thin, telescope–like hose with a tiny attached camera called a cystoscope is inserted into the bladder through the urethra (the tube that passes urine from the bladder out of the body). A local anesthetic jelly is used during the procedure. The physician maneuvers the cystoscope to detect any abnormalities in the urinary tract. Special attention is paid to the opening of the ureter into the bladder (ureteral opening), where many tumors begin to grow. The physician will inspect the bladder from numerous angles, and may apply pressure on the abdomen to view areas such as the bladder dome.

If a tumor is seen or suspected (for example, a papillary tumor or CIS) or if the urine cytology test is positive, then the physician will want to conduct cystoscopy in an operating room while the patient is under general anesthesia. In this way, the physician can thoroughly inspect the bladder, obtain a biopsy (small sample of tissue), and cut away any tumors or lesions in a process known as transurethral resection (TUR). The removed tissue will then be submitted for histopathological examination – an evaluation of diseased tissue for abnormalities such as cancerous changes. In addition, the physician will make a map of the shape and location of all biopsies. Once a bladder tumor has received a histopathologic diagnosis, it will be assigned a grade and stage, which will determine the form(s) of treatment.

After cystoscopy, the physician may want to perform other diagnostic tests such as computed tomography, and bone scans to thoroughly evaluate the upper urinary tract and identify or rule out distant metastases.


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