CancerBro, what are the bladder cancer diagnosis/investigations?
Urine analysis is a useful investigation to diagnose bladder cancer. It helps in detecting the presence of blood, malignant cells, and tumor markers in urine. Next important investigation for the diagnosis of bladder cancer is cystoscopy.
In this technique, a hollow tube called a cystoscope which is fitted with a camera is inserted into the urethra and is slowly advanced into the bladder. It helps to confirm the presence of a bladder tumor and see it’s number, location, and extent. Also, it helps in transuretheral resection of bladder tumor which is both, diagnostic as well as therapeutic.
As you can see in this figure, only cancer containing superficial layers of the bladder is removed, without damaging the deeper layers. The next imaging modality used for diagnosis of bladder cancer is Intravenous Pyelogram. In this technique, a dye is injected into the arm vein and then a series of X-ray pictures are taken of the urinary tract. In some cases, we may require a Retrograde Pyelogram in which a dye is injected into the ureter with the help of cystoscope, followed by a series of images.
Pyelogram may be complemented with other imaging modalities, like CT scan or MRI, which help in better delineating the urinary tract. Also, CT scan or MRI of the abdomen and pelvis helps to understand the local extention of the tumor to other structures and the involvement of reginal lymph nodes.
It also helps to diagnose the metastatic involvement of other structures. Imaging of the chest with X-ray or CT scan may be required if clinically indicated. Also, a bone scan may be done if there is a clinical suspicion of bone metastases.
These were the investigations required to confirm the diagnosis of bladder cancer and stage the disease.
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