Diagnosing bladder cancer often begins with a thorough discussion with a physician to review symptoms and risk factors. A physical exam is typically performed and includes a rectal and prostate exam (for men) or a recto-vaginal exam (for women) to examine the bladder for abnormal tissues (i.e., tumors). If abnormal tissues are detected, the physician will order:

• Urinalysis and urine culture: A urinalysis and urine culture to ensure an infection isn’t causing the symptoms. Depending on the outcome of the urinalysis and urine culture, more sophisticated testing will be ordered (i.e., a urine cytology), which involves laboratory testing of cancer cells.
• Cystoscopy: A cystoscopy may be performed in the urologists office using a flexible tube attached to a small camera, inserted into the urethra and bladder to inspect the lining of the bladder for a tumor.
• Biopsy: The urologist can take a biopsy of the bladder at this time. If no tumor is seen, imaging test may be ordered (i.e., CT or MRI).

Bladder cancer staging uses the TNM system. T describes how far the tumor has grown through the bladder wall and whether it is into nearby tissues. N indicates if any cancer has spread to lymph nodes near the bladder. M indicates if the cancer has spread, or metastasized) to distant sites such as other organs. After the T, N and M there may be numbers or letters to provide more details about each of the above factors. The higher the number means the cancer is more advanced. Standard bladder cancer staging allows medical professionals to quickly refer to the severity of the case.

Treating bladder cancer depends upon the stage of the bladder cancer and also the health of the patient. Many times, the best option might delay treatment if the tumor is caught very early. However, other treatments may include:

• Surgery to remove the tumors and a healthy margin of surrounding tissue.
• Intravesical chemotherapy, which directly administers medication into the bladder through a catheter to destroy any leftover, non-visible cancer cells.
• Intravesical Immunotherapy, which triggers the patient’s own immune system to kill cancer cells.
• Monitoring may be ongoing following bladder cancer treatments, it is important to monitor the bladder and the patients’ health.