How it is diagnosed

Usually, you begin by seeing your GP, who will examine you and ask you to give a urine sample. The examination may include an internal examination of the back passage (rectum) in men, and an internal examination of the rectum and vagina (birth canal) in women.

The urine sample will be sent to a laboratory to be checked under a microscope for any cancer cells. Your GP may also arrange for further tests or x-rays. They will need to refer you to hospital for these tests, and for specialist advice and treatment.

The following tests may be used to diagnose cancer of the bladder:

Cystoscopy and biopsy

The most important test is a cystoscopy. It can be done while you are under a local or general anaesthetic.

In most cases it is done first under local anaesthetic, because this is the quickest and simplest way. A small, flexible, fibre-optic telescope (cystoscope) is passed into the urethra to allow the doctor to look at the whole lining of the bladder and urethra.

If any abnormal area that could be a bladder cancer is seen, you will be given a general anaesthetic. The doctor will then either take a small sample of the abnormal cells from the inside of the bladder, or take several samples of the lining of the bladder. This is called a biopsy. A pathologist then examines the samples under a microscope in a laboratory.

Blood tests

Samples of your blood will be taken to check your general health, the number of cells in your blood (blood count), and to see how well your kidneys and liver are working.

Chest x-ray

This is taken to check that your lungs and heart are healthy.

Intravenous urogram (IVU or IVP)

This test is also known as an intravenous pyelogram (IVP). It is done in the hospital x-ray department and takes about an hour.

A dye is injected into a vein, usually in the arm, and goes through the bloodstream to the kidneys. The doctor can watch the passage of the dye on an x-ray screen and see any abnormalities in the kidneys, bladder and the rest of the urinary system.

The dye will probably make you feel hot and flushed for a few minutes, but this feeling gradually disappears. You may feel some discomfort in your abdomen, but this will only be for a short time. You should be able to go home as soon as the test is over.