Bladder cancer: diagnosis and management

Looking inside your bladder

If you have been referred to a urologist and they think you might have bladder cancer, they should offer you a procedure called a cystoscopy to look inside your bladder. A thin instrument called a cystoscope is inserted into your bladder through your urethra. The cystoscope has a light and a small camera that allows the inside of your bladder to be seen.

If anything looks abnormal inside your bladder, you should be offered an operation to do a procedure called a biopsy, in which samples of tissue from you bladder are removed for testing (see taking tissue samples for testing). If it is thought that you might have a bladder cancer that has spread to the muscle wall of your bladder, you may also be offered a CT scan or an MRI scan to give a more detailed picture.

Taking tissue samples for testing

You should be offered an operation called transurethral resection of bladder tumour (or TURBT for short) to take tissue samples from your bladder. During the operation the areas of tissue that look abnormal are removed so that they can be tested for cancer. Samples of tissue from the muscle wall of your bladder should also be taken. This is to check whether there is a cancer that has spread to the muscle.

You should be offered a dose of chemotherapy with a drug called mitomycin C, which is given to you at the end of your TURBT operation. If the abnormal tissue in your bladder is cancerous, the mitomycin C may help to stop bladder cancer coming back later.

Sometimes the tissue samples that are taken don't include tissue from the muscle wall. If this happens you may be offered another TURBT operation to take these samples, which should be done within 6 weeks of your first operation.

After your operation, if it's confirmed that you do have bladder cancer, you should be told whether or not the cancer has spread to the muscle wall of your bladder. You should be offered information, support and treatment as described in the next sections.