Bladder Cancer Tests, Diagnosis, Stages, and Prognosis

The caring team at Banner MD Anderson Cancer Center offers a range bladder cancer tests tailored to your individual care needs.

What tests are used to diagnose bladder cancer?

Urine tests 

Urine cytology: This test examines urine under a microscope to detect abnormal cells. Your doctor may collect a sample during a cystoscopy or you can provide a urine sample directly. 

Blood tests 

• Comprehensive metabolic panel (CMP): These blood tests assess kidney and liver function, which can help evaluate overall health before or during treatment. 

Cystoscopy 

A thin, flexible tube with a camera (cystoscope) is inserted through the urethra to view the bladder. Your doctor may also take a tissue sample (biopsy). This outpatient procedure typically takes 5 to 10 minutes. 

Imaging tests 

• CT urogram: A specialized CT scan of the bladder, ureters, and kidneys that uses x-rays to create 3D images. It helps identify tumor size and location. The scan usually takes 60 to 90 minutes as an outpatient. 
• MRI (magnetic resonance imaging): MRI scans use magnets instead of x-rays to detect cancer and whether it has spread to nearby tissue. This outpatient test takes about an hour. 
• Ultrasound: Sound waves create images of the bladder and nearby organs to check tumor size and spread. An ultrasound typically takes under 30 minutes. 
• PET scan (positron emission tomography): This scan uses a small amount of radioactive tracer to show how organs and tissues are functioning and may detect cancer spread. 
• Bone scan: Used to detect cancer spread to the bones or identify other bone abnormalities. 

Genetic testing 

Genetic testing may be recommended if you have a family history or other risk factors for bladder cancer. It looks for changes in chromosomes, genes or proteins to assess your risk of developing or passing on a genetic disorder.  

What are the stages of bladder cancer?

Bladder cancer staging refers to how far the cancer has progressed in the body. Stage 0 is the earliest and stage 4 is the most advanced. Your doctor will explain what stage your stage means and how it affects treatment options.

• Stage 0: Early-stage cancer found only on the inner lining of the bladder (in situ). Cancer cells are grouped together and may be removed easily.
• Stage 1: Cancer is in the bladder lining but hasn’t reached the bladder muscle or other organs.
• Stage 2: Cancer has grown into the bladder muscle but hasn’t spread beyond the bladder.
• Stage 3: Cancer has spread into nearby fatty tissue, lymph nodes or organs (like the prostate in men, or uterus/vagina in women).
• Stage 4: Cancer has spread to distant parts of the body (metastasized). 

What is the prognosis for bladder cancer

The earlier bladder cancer is diagnosed, the better the chance for successful treatment. However, many people are not diagnosed with bladder cancer until symptoms appear, which often happens in the later stages of the disease.

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