Bladder cancer examination Some doctors will do rectal examination (and pelvic examination for female patients) during the consultation to determine whether the bladder tumor is palpable and whether it invades out of the bladder. Other common tests include: 1) urine exfoliation cytology or other urine screening; 2) abdominal plain film and intravenous urography; 3) cystoscopy to examine the inside of the bladder under direct vision, and the doctor may also do a biopsy, which is to grab a few pieces of tissue suspected to be a tumor. The biopsy specimen will be sent to a pathologist who will diagnose the exact type of tumor and the depth of infiltration under a microscope, and further tests and treatment will be based on the biopsy results.
Regardless of the biopsy results, each patient must undergo an x-ray of the upper urinary tract, i.e. abdominal plain film and intravenous urography, to confirm that the kidneys and ureters are free of tumors, as these two parts are not visible under cystoscopy. You may also need to have your heart checked again, such as an electrocardiogram or echocardiogram, especially if your doctor decides to perform a biopsy under anesthesia or to do a tumor removal in the operating room. If there are abnormalities in these tests, you will need to be further evaluated by a cardiologist. In addition, there are some patients, especially those over 50 years of age or who smoke, who need a chest x-ray before receiving anesthesia. Finally, patients with suspected more advanced bladder cancer will need a CT of the abdomen and pelvis to assess whether the tumor has invaded the bladder and to determine the presence of enlarged lymph nodes.