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Bladder cancer (view source)

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[[Haematuria]] on [[urine analysis]] is seen in most cases of bladder cancer. Urine cytology may show cancer cells.
[[Haematuria]] on [[urine analysis]] is seen in most cases of bladder cancer. Urine cytology may show cancer cells.


Patients suspected of having bladder cancer should be referred to [[cystoscopy]]. Cystoscopy allows for taking biopsy sample, cytology sample, or even resecting the tumour in its entirety in some cases. <section end="pathology" />Photodynamic diagnosis (PDD) is often used in cystoscopy, where a fluorescent dye called hexyl aminolevulinate (HAL, Hexvix®) is administered into the bladder. Cancer cells absorb this dye and glow red or pink when special fluorescent light is shone from the cystoscope, making them easier to see.
Patients suspected of having bladder cancer should be referred to [[cystoscopy]]. Cystoscopy allows for taking biopsy sample, cytology sample, or even resecting the tumour in its entirety in some cases. <section end="pathology" />


[[CT]] with contrast is the first choice imaging modality if bladder cancer is suspected based on cystoscopy. It allows for visualisation of the local spreading of the malignancy. Because contrast is filtered by the kidneys, it enters the urinary tract, and a tumour may therefore produce a filling defect. If the tumour has invaded the bladder wall, it will appear thickened on the CT. CT urography also allows for examination of the entire urinary tract, as bladder cancer is often multifocal. CT abdomen and pelvis to look for metastasis is also indicated for staging. In Norway, CT of the abdomen is performed before cystoscopy (because positive findings may allow the patient to skip cystoscopy and proceed directly to TUR-B).
[[CT]] with contrast is the first choice imaging modality if bladder cancer is suspected based on cystoscopy. It allows for visualisation of the local spreading of the malignancy. Because contrast is filtered by the kidneys, it enters the urinary tract, and a tumour may therefore produce a filling defect. If the tumour has invaded the bladder wall, it will appear thickened on the CT. CT urography also allows for examination of the entire urinary tract, as bladder cancer is often multifocal. CT abdomen and pelvis to look for metastasis is also indicated for staging. In Norway, CT of the abdomen is performed before cystoscopy (because positive findings may allow the patient to skip cystoscopy and proceed directly to TUR-B).