How Does My Doctor Know I Hav... Health Article

If you’re having bladder-cancer-like symptoms, your doctor will want to know why. Your doctor is likely to ask you questions about these things.

• Your medical history, including whether you have taken the chemotherapy drug Cytoxan (cyclophosphamide) or Ifex or Isophosphamide (ifosfamide) or had radiation treatment in the pelvic area

• Your smoking history

• Your history of exposure to certain types of chemicals in the workplace

• Your history of bladder infections or other things that may cause physical trauma to the bladder. This may include a parasitic infection in the bladder, called schistosomiasis, which is more common in third-world countries.

• Your family history of cancer

• Other risk factors that may cause chronic irritation to the bladder

In addition to asking you questions, your doctor may also do one or all of these tests.

A urinalysis. The goal of this test is to look for signs of infection since infections and cancer can have some of the same symptoms. For the test, you urinate into a clean jar. Then your urine is checked in a lab for signs of infection. The urine is cultured to see if organisms, such as bacteria, grow. It usually takes a few days for the test results to come back. A test that shows an infection may explain the symptoms.

A urine cytology test. For this test, you urinate into a clean jar. Then your urine is looked at in a lab under a microscope. Cells from the lining of the bladder, called epithelial cells, normally shed off into the urine. The cells are examined to see if any of them are cancerous or precancerous.

NMP22 test For this test, you urinate into a clean jar. Then your doctor checks for the level of nuclear matrix proteins (NMPs). These are found in normal and cancerous cells, but people with bladder cancer usually have higher levels.

FISH test. For this test, you urinate into a clean jar. Then your urine is checked for certain abnormal cells using a process called fluorescence in situ hybridization (FISH).

Cystoscopy.  This procedure lets your doctor examine the inside of your bladder. Your doctor slides a thin tube with an attached tiny camera lens and light, called a cystoscope, throu

gh your urethra into your bladder. If your doctor sees anything that looks like cancer, he or she might remove a small sample of the tissue for examination. Your doctor may decide to take a urine sample with a bladder wash during a cystoscopy. This is when a salt-water solution is placed into the bladder through a tube inserted in the urethra. The solution is then removed and examined under a microscope. 

The results of these exams may show that you don’t have cancer. Or the results may require additional tests. For example, your doctor may need to remove cells and tissue from a suspicious area found in your bladder. This is called a biopsy. If the area looked suspicious during the cystoscopy, but the biopsy came back negative for cancer, the biopsy may need to be repeated.