Overview

What bladder cancer tests may be performed to help diagnose bladder cancer?  Diagnosis begins with a medical history and physical examination.  Any of a number of tests may be performed to confirm a diagnosis of bladder cancer.

Urine Culture test
A sample of urine is tested in the lab to check for the presence of bacteria. (This test is performed to rule out infection as the cause of urinary symptoms.)

Urine Cytology test
A urine sample is examined under a high-powered microscope to look for cancerous or pre-cancerous cells eliminated from the bladder.

Flow Cytometry test
Bladder cell samples are tested in the lab to determine DNA content.

Cystoscopy test
A thin lighted tube (the cystoscope) is inserted by a trained physician through the urethra into the bladder to view the inside of the bladder.

Biopsy test
If suspicious growths are detected during cystoscopy, a small sample of tissue is taken. The tissue sample is examined in the lab under the microscope, to check for the presence of cancerous cells, and to identify the type of cancer.

Intravenous Pyelogram test
A dye is injected into the bloodstream The dye travels to the urinary system, outlining the kidneys, ureters, and bladder for x-ray examination.

DNA-Probe Based (UroVysionTM) Test
The UroVysion bladder cancer recurrance kit is the first and only DNA probe test to directly examine bladder cell DNA for signs of cancer.  From voided urine, it employs flourescence in situ hybridization (FISH) technology, which uses small, fluorescent labeled DNA probes to make visible specific regions of DNA.

Bladder Tumor Marker Measurements test
Urine is tested for the presence of proteins released by cancerous bladder cells.  These tests miss fewer cancers than cytology.  However, due to their tendency to generate more false-positives, they have not replaced cytoscopy.  (False positives are results indicative of  malignancy when in actuality the patient does not have cancer.)

  • NMP22-A protein found inside the bladder cells
  • BTA-This protein is measured in the urine itself.
  • Immunocyt® antibodies that attaches specifically to tumor cells.  

Additional markers are in the process of being tested, including:

  • HA-HAase
  • CYFRA 21-1 

Other strategies are also being researched
Another is the enzyme telomerase, which is primarily released by cancer cells, versus non-cancerous cells.

The UroVysion Bladder Cancer Kit (UroVysion Kit) is designed to detect aneuploidy for chromosomes 3, 7, 17, and loss of the 9p21 locus via fluorescence in situ hybridization (FISH) in urine specimens from persons with hematuria suspected of having bladder cancer. Results from the UroVysion Kit are intended for use, in conjunction with and not in lieu of current standard diagnostic procedures, as an aid for initial diagnosis of bladder carcinoma in patients with hematuria and subsequent monitoring for tumor recurrence in patients previously diagnosed with bladder cancer.