Materiały źródłowe

• #1 Bladder cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bladder-cancer/diagnosis-treatment/drc-20356109

  Get answers to the most frequently asked questions about bladder cancer from urologist Mark Tyson, M.D., M.P.H. […] The type of bladder cancer that most patients are diagnosed with is urothelial carcinoma. […] The grade, the stage, and the type of cancer are all used to determine the type of treatment that you will receive. […] Tests and procedures used to diagnose bladder cancer may include: Using a scope to examine the inside of your bladder (cystoscopy). […] During cystoscopy, your doctor may pass a special tool through the scope and into your bladder to collect a cell sample (biopsy) for testing. […] A sample of your urine is analyzed under a microscope to check for cancer cells in a procedure called urine cytology. […] After confirming that you have bladder cancer, your doctor may recommend additional tests to determine whether your cancer has spread to your lymph nodes or to other areas of your body.

• #1 Bladder Cancer: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1015/p507.html

  Bladder cancer is the sixth most prevalent malignancy in the United States and causes more than 16,000 deaths annually. The most common clinical presentation is asymptomatic hematuria, which should prompt evaluation with cystoscopy, renal function testing, and upper urinary tract imaging in adults 35 years and older and in those with irritative voiding symptoms, risk factors for bladder cancer, or gross hematuria at any age. […] Cystoscopy should be performed in all patients with gross hematuria and in those 35 years and older with microscopic hematuria, and it can be considered for younger patients with microscopic hematuria. Patients with hematuria and risk factors for bladder cancer (e.g., tobacco use, irritative voiding symptoms, chemical exposures) should be evaluated with cystoscopy regardless of age.

• #1 Bladder Cancer Diagnosis – NCI

  https://www.cancer.gov/types/bladder/diagnosis

  If you have symptoms or lab test results that suggest bladder cancer, your doctor will need to find out if theyre due to cancer or another condition. […] Depending on your symptoms, medical history, and results of your urine lab tests and physical exam, your doctor may recommend more tests to find out if you have bladder cancer, and if so, its extent (stage). […] The following tests and procedures are used to diagnose bladder cancer. […] Cystoscopy is a procedure in which the doctor looks inside the bladder and urethra (the tube that carries urine out of your body) to check for abnormal areas. […] A biopsy is usually done during a cystoscopy procedure. […] CT urogram is a test that takes a CT scan of the urinary tract using a contrast dye injected into a vein. […] IVP is an x-ray imaging test of your urinary tract.

• #1 Diagnosis of bladder cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/bladder/diagnosis

  Diagnosis is the process of finding out the cause of a health problem. Diagnosing bladder cancer usually begins with a visit to your family doctor. Your doctor will ask you about any symptoms you have and may do a physical exam. Based on this information, your doctor may refer you to a specialist or order tests to check for bladder cancer or other health problems. […] The following tests are usually used to rule out or diagnose bladder cancer. Many of the same tests used to diagnose cancer are used to find out how far the cancer has spread (the stage). Your doctor may also order other tests to check your general health and to help plan your treatment. […] A physical exam allows your doctor to look for any signs of bladder cancer. During a physical exam, your doctor may do a pelvic exam or a digital rectal exam (DRE).

• #1 Tests for bladder cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/bladder-cancer/getting-diagnosed/tests-for-bladder-cancer

  You usually have a number of tests to find out if the symptoms you have could be due to bladder cancer. If you have bladder cancer, you then need more tests to find out how far it has grown. […] Your GP can do a quick test to see if there is any blood in your urine. […] The doctor can sometimes feel a bladder tumour during this type of examination. […] Your specialist usually does more tests. These include: ultrasound scan of your tummy (abdomen), cystoscopy for bladder cancer – to look inside your bladder, CT urogram – to check your kidneys, bladder and ureters, blood tests for bladder cancer, MRI scan, CT scan, chest x-ray, bone scan. […] The ultrasound scan can show if there are any signs of cancer in your bladder. […] Cystoscopy is a test to look at the inside of your bladder and check for signs of cancer. Your doctor can take biopsies of the bladder lining to check for cancer cells.

• #1 Bladder Cancer Diagnosis – NCI

  https://www.cancer.gov/types/bladder/diagnosis

  Urinary tumor markers are substances found in the urine that are either made by bladder cancer cells or that the body makes in response to bladder cancer. […] If youre diagnosed with bladder cancer, you will be referred to a urologic oncologist. […] The process of learning the extent of cancer in the body is called staging. […] A CT scan uses a computer linked to an x-ray machine to make a series of detailed x-ray pictures of areas inside the body from different angles. […] MRI uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body, such as the bladder. […] A chest x-ray is an x-ray of the organs and bones inside the chest. […] A bone scan is a procedure that checks to see if there are rapidly dividing cells, such as cancer cells, in the bone. […] Some people may want to get a second opinion to confirm their bladder cancer diagnosis and treatment plan.

• #1 Detecting Bladder Cancer with a Urine Test | Cxbladder

  https://www.cxbladder.com/nz/bladder-cancer/detection/urine-test-detection/

  Notably, no single test is best able to detect bladder cancer, and usually different types of tests (i.e., urine tests, cystoscopy, and imaging techniques) are used in combination. […] Urinalysis examines several physical, chemical, and microscopic features of urine samples. […] The most common early sign of bladder cancer is the presence of blood in the urine (haematuria). […] Urine cytology refers to the microscopic examination of cells from urine samples. […] Recent analyses indicate that urine cytology detects only around 50% of high-grade tumours and 10% of low-grade tumours, with an overall sensitivity for bladder cancer detection of approximately 40%. […] A urine tumour marker is simply defined as a biological molecule found in urine that indicates the presence of bladder cancer. […] Cxbladder is a non-invasive and easy-to-use genomic urine test that analyses five biomarker genes to quickly and accurately rule out bladder cancer.

• #1 Advances in diagnosis and treatment of bladder cancer | The BMJ

  https://www.bmj.com/content/384/bmj-2023-076743

  Evaluation of patients suspected of having bladder cancer is performed using cystoscopy. Cystoscopy remains the gold standard procedure for the initial diagnosis of bladder cancer. Any abnormal finding, such as reddish flat, papillary, or solid lesions, requires pathological evaluation, because inflammatory and other benign conditions can mimic bladder cancer. Cystoscopic detection of carcinoma in situ can be enhanced by fluorescence cystoscopy or narrow band imaging, both of which can be performed with flexible endoscopic equipment in the office. These technologies improve the differentiation of tumorous lesions from normal tissue by taking advantage of the increased metabolic activity (blue light) and vessel architecture (narrow band) in cancer tissues and they have higher specificity for bladder cancers than traditional cystoscopy.

• #1 Tests for Bladder Cancer | Diagnosing Bladder Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/bladder-cancer/detection-diagnosis-staging/how-diagnosed.html

  Bladder cancer is often found because of signs or symptoms a person is having. Sometimes it might be found because of the results of a lab test a person gets for another reason. […] If bladder cancer is suspected, exams and tests will be needed to confirm the diagnosis. If cancer is found, more tests will be done to help find out the extent (stage) of the cancer. […] If the results of the history and exam suggest bladder cancer might be the cause, the doctor will order lab tests to help find out for sure. […] If bladder cancer is suspected, your doctor will likely recommend a cystoscopy, which is a procedure done by a urologist. […] A cystoscopy can often be used to make the initial diagnosis of bladder cancer, but this typically needs to be confirmed with a transurethral resection of bladder tumor (TURBT), also known as just a transurethral resection (TUR).

• #1 Advances in diagnosis and treatment of bladder cancer | The BMJ

  https://www.bmj.com/content/384/bmj-2023-076743

  Accurate staging is of outmost importance in bladder cancer to determine the appropriate treatment after initial TURBT. Thus, a repeat TURBT is recommended within 2-6 weeks in patients with a known incompletely resected tumor or with tumors invading the lamina propria (T1), and should be considered in high grade non-invasive disease (except carcinoma in situ alone) to improve staging accuracy and increase recurrence free survival. Thus, repeating TURBT after newly diagnosed T1 bladder cancer improves recurrence free and progression free survival at five years by 25% and 14%, respectively. […] NMIBC is managed initially with TURBT, followed by a risk stratified approach to adjuvant IVe, and is associated with a 90% overall survival. By contrast, cure rates remain lower for MIBC. Tumor heterogeneity with unique pathological and molecular characteristics is behind the observed differences of NMIBC and MIBC groupings. For NMIBC, IVe immunotherapy (primarily BCG) remains a gold standard treatment for high risk disease to reduce or prevent both recurrence and progression after initial TURBT; recently completed novel trials have incorporated immune checkpoint inhibitors, IVe gene treatment, and combination IVe chemotherapy, with promising results in reducing recurrence and progression to MIBC.

• #1 Bladder cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bladder-cancer/diagnosis-treatment/drc-20356109

  Your doctor uses information from these procedures to assign your cancer a stage. […] Bladder cancers are further classified based on how the cancer cells appear when viewed through a microscope. […] A low-grade tumor usually grows more slowly and is less likely to invade the muscular wall of the bladder than is a high-grade tumor. […] A high-grade tumor tends to grow more aggressively than a low-grade tumor and may be more likely to spread to the muscular wall of the bladder and other tissues and organs. […] Cystoscopy allows a health care provider to view the lower urinary tract to look for problems, such as a bladder stone. […] Cystoscopy allows a health care provider to view the lower urinary tract to look for problems in the urethra and bladder. […] Imaging tests, such as computerized tomography (CT) urogram or retrograde pyelogram, allow your doctor to examine the structures of your urinary tract. […] The lowest stages indicate a cancer that’s confined to the inner layers of the bladder and that hasn’t grown to affect the muscular bladder wall. The highest stage stage IV indicates cancer that has spread to lymph nodes or organs in distant areas of the body.

• #1 EAU Guidelines on Non-muscle-invasive Bladder Cancer – Uroweb

  https://uroweb.org/guidelines/non-muscle-invasive-bladder-cancer/chapter/diagnosis

  A focused patient history is mandatory. […] Haematuria is the most common finding in NMIBC. Visible haematuria was found to be associated with higher stage at diagnosis disease compared to nonvisible haematuria. Carcinoma in situ might be suspected in patients with lower urinary tract symptoms, especially irritative voiding symptoms. […] A focused urological examination is mandatory although it does not reveal NMIBC. […] Computed tomography (CT) urography is used to detect papillary tumours in the urinary tract, indicated by filling defects and/or hydronephrosis. […] Intravenous urography (IVU) is an alternative if CT is not available, but CT urography provides more information particularly in muscle-invasive tumours of the bladder and in UTUCs (including status of lymph nodes and neighbouring organs).

• #1 Bladder Cancer: Tests After Diagnosis | University Hospitals

  https://www.uhhospitals.org/health-information/health-and-wellness-library/article/adult-diseases-and-conditions-v0/bladder-cancer

  After a diagnosis of bladder cancer, you will likely need more tests. These tests help your healthcare providers learn more about the cancer. They can help show if it has grown into nearby tissues or spread to other parts of your body. The test results help your healthcare providers work with you to decide the best ways to treat the cancer. […] IVP is used to find tumors, other changes, or blockages. It can show the blood flow through your kidneys. It can also be used to check for spread (metastasis) of the bladder cancer to other parts of the urinary tract. […] Ultrasound can be used to help figure out if the cancer has spread from your bladder to other nearby tissues. […] CT scans can be used to find out the size of the tumor, exactly where it is, and if it has spread to nearby tissues or lymph nodes.

• #1 Diagnosing Bladder Cancer | NYU Langone Health

  https://nyulangone.org/conditions/bladder-cancer/diagnosis

  A CT scan may be used to see whether bladder cancer has invaded the bladder wall or has spread to other organs or nearby lymph nodes. […] If a CT scan cant be performed or doesnt provide sufficient imaging of the bladder, doctors may order an MRI scan. […] If doctors need more detailed images of the bladder and surrounding organs to see if the cancer has spread, they may use a combined PET/CT scan to evaluate them. […] Our doctors were the first to illustrate that PET/MRI technology can improve the ability to determine whether bladder cancer has spread. […] Based on your test results, Perlmutter Cancer Center doctors create a customized treatment plan for you.

• #1 EAU Guidelines on Non-muscle-invasive Bladder Cancer – Uroweb

  https://uroweb.org/guidelines/non-muscle-invasive-bladder-cancer/chapter/diagnosis

  The necessity to perform a baseline CT urography once a bladder tumour has been detected is questionable due to the low incidence of significant findings which can be obtained. […] Ultrasound (US) may be performed as an adjunct to physical examination as it has moderate sensitivity to a wide range of abnormalities in the upper- and lower urinary tract. […] Multi-parametric magnetic resonance imaging (mpMRI) may provide additional information regarding the local staging of BC. […] A diagnosis of CIS cannot be made with imaging methods alone (CT urography, IVU, US or MRI). […] The examination of voided urine or bladder-washing specimens for exfoliated cancer cells has high sensitivity in HG and G3 tumours (84%), but low sensitivity in LG/G1 tumours (16%). […] Cytology is useful, particularly as an adjunct to cystoscopy, in patients with HG/G3 tumours; it is not designed to detect LG tumours.

• #1 Tests for Bladder Cancer | Diagnosing Bladder Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/bladder-cancer/detection-diagnosis-staging/how-diagnosed.html

  Biopsy samples (from a cystoscopy or TURBT) are sent to a lab, where they are looked at and tested by a pathologist, a doctor trained in diagnosing diseases such as cancer with lab tests. If bladder cancer is found, 2 important features are its invasiveness (part of the stage) and grade. […] If imaging tests suggest the cancer might have spread outside of the bladder, a biopsy might be needed to be sure.

• #1 Patient education: Bladder cancer diagnosis and staging (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bladder-cancer-diagnosis-and-staging-beyond-the-basics/print

  Imaging tests can help to detect any masses or abnormalities in the kidneys, ureters, bladder, or urethra. […] Cystoscopy, also called cystourethroscopy, is a procedure that is done to examine the lining of the urethra and bladder. […] If abnormal tissue is seen, a biopsy can be taken. Biopsies may be done in the office or in the operating room. The biopsy specimen(s) is examined with a microscope to determine if cancerous cells are present. […] After the diagnosis of bladder cancer is confirmed, one or more tests may be performed to stage the disease. […] The most commonly used system for staging is the TNM system (Tumor, Node, Metastasis). […] A cancer’s grade refers to how the cancer cells appear under the microscope. Grade is one factor used to predict how likely the cancer is to recur after treatment and, ultimately, the person’s chance of surviving his or her cancer.

• #1 Bladder Cancer Diagnosis and Follow-Up: The Current Status and Possible Role of Extracellular Vesicles

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6412916/

  Diagnostic methods currently used for bladder cancer are cystoscopy and urine cytology. Cystoscopy is an invasive tool and has low sensitivity for carcinoma in situ. Urine cytology is non-invasive, is a low-cost method, and has a high specificity but low sensitivity for low-grade urothelial tumors. Despite the search for urinary biomarkers for the early and non-invasive detection of bladder cancer, no biomarkers are used at the present in daily clinical practice. […] Current diagnostic tools to detect bladder cancer are cystoscopy and cytology. Cystoscopy is an effective but invasive tool to detect bladder cancer tumors. Moreover, it has a low sensitivity for carcinoma in situ (Tis) and tumors can still be missed because effectiveness is operator-dependent, especially for the detection of recurrence. Sensitivity and specificity range from 62 to 84% and 43 to 98%, respectively, depending on the type, stage, and grading of the tumor.

• #1 Diagnosis and Treatment of Non-muscle Invasive Bladder Cancer | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/get-involved/nominated-topics/diagnosis-and-treatment-of-non-muscle-invasive-bladder-cancer

  Diagnosis and Treatment of Non-muscle Invasive Bladder Cancer […] How do the accuracies of imaging tests, cystoscopy, urine cytology, urine-based biomarkers, transurethral resection of bladder tumor (TURBT) and new cystoscopic techniques compare to one another in the screening, diagnosis and staging of non-muscle invasive (clinically localized) bladder cancer? […] In recent years, there has been an intense search for non-invasive, adjunctive urine-based markers that could improve or perhaps replace cytology and cystoscopy in the diagnosis and surveillance of patients with urothelial cancers. The evidence report should compare the effectiveness of the various diagnostic methods for detection of bladder cancer: Cystoscopy, TURBT, Urine cytology, Urine-based biomarkers, Imaging tests. […] Controversy surrounds the use of the previously mentioned urine-based biomarkers in the diagnosis of bladder cancer. The evidence report should include information on the performance characteristics of these tests as well as additional biomarkers currently under investigation. […] The evidence report should include analysis and comparisons of treatment options for non-muscle invasive (clinically localized) bladder cancer, including information on oncologic outcomes, functional outcomes and quality of life for each management strategy. […] There is currently a tremendous amount of research looking into genetic variants that predispose one to bladder cancer in hopes of earlier detection. Additionally, research is also looking into newer tests for substances in the urine that might indicate that a person has bladder cancer. […] While physicians continue to look for non-invasive diagnostic tools, the risk of a missed diagnosis is a constant concern. Additionally, there are multiple options for both chemotherapy and immunotherapy in addition to surgery following a diagnosis of bladder cancer; however, all options are associated with various side effects. […] The single most important risk factor for bladder cancer is smoking, which is accountable for approximately half of all female cases of bladder cancer. […] The most common symptom of bladder cancer is hematuria, most often gross, episodic and not associated with any type of pain. Other symptoms include frequent urination, painful urination.

• #1 Urine Tumor Markers in Bladder Cancer Diagnosis: Overview of Urine Tumor Markers, Genetic Aberrations in Bladder Cancer, Fluorescence In Situ Hybridization

  https://emedicine.medscape.com/article/1953022-overview

  More than 30 urinary biomarkers have been reported for use in bladder cancer diagnosis, but only a few are commercially available; the remainder are still being tested. In addition to urine cytology, tests approved or cleared for marketing by the US Food and Drug Administration (FDA) for bladder cancer diagnosis and/or surveillance include the following: BTA stat: Bladder tumor antigen point of care immunoassay, BTA TRAK: Reference laboratory immunoassay, Cxbladder: Measures the expression of 5 genes (MDK, HOXA13, CDC2, IGFBP5, CXCR2), NMP22 BladderChek: Nuclear matrix protein22 point of care qualitative immunoassay, NMP22 Bladder Cancer Test: In vitro quantitative enzyme-linked immunosorbent assay (ELISA), uCyt+ (formerly ImmunoCyt): Fluorescent monoclonal antibodies against M344, LDQ10, and 19A211, Vysis UroVysion: Fluorescence in situ hybridization (FISH) probe set, Xpert Bladder Cancer Monitor: Measures mRNA (ABL1, CRH, IGF2, UPK1B, ANXA10) in voided urine by reverse transcription polymerase chain reaction (RT-PCR).

• #1 Urine Tumor Markers in Bladder Cancer Diagnosis: Overview of Urine Tumor Markers, Genetic Aberrations in Bladder Cancer, Fluorescence In Situ Hybridization

  https://emedicine.medscape.com/article/1953022-overview

  For the present, cystoscopy remains the gold standard for detecting bladder cancers. However, it is invasive, relatively expensive, and operator dependent, and has potential complications that include infection, bleeding, perforation, and urinary retention. Urine cytology is still the most accurate noninvasive test for bladder cancer that is in routine clinical use, with a sensitivity of 80-90% and a specificity of 98-100% for detection of high-grade lesions and carcinoma in situ (CIS). The disadvantages of urine cytology are that it is relatively ineffective at detecting low-grade malignancy, and benign inflammatory conditions may result in false positive results. […] Use of urine biomarkers in the initial diagnosis of bladder cancer is controversial. All of these assays may yield false-positive and false-negative results. At present, guidelines do not recommend using the biomarker assays that are currently available to replace cystoscopy. However, biomarker assays may provide additional molecular information to guide individualized surveillance and therapy.

• #1 Bladder Cancer | Choose the Right Test

  https://arupconsult.com/content/bladder-cancer

  The National Comprehensive Cancer Network (NCCN) recommends that molecular testing for genetic variants be considered in patients with muscle-invasive bladder cancer (stage IIIB) and that this testing be performed in all patients with stage IVA, stage IVB, and metastatic disease. […] The NCCN recommends that genetic testing be performed promptly following diagnosis of advanced cancer to avoid delays in decision-making. […] Testing for bladder cancer should be considered in patients with hematuria, urinary frequency, dysuria, urinary tract infections, pelvic pain, back pain, or other symptoms associated with upper urinary tract obstruction, which can occur in advanced disease. […] The National Comprehensive Cancer Network (NCCN) recommends cystoscopy be performed as part of the initial evaluation in all cases of suspected bladder cancer. Enhanced cystoscopy should be performed if available.

• #2 Bladder cancer – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bladder-cancer/symptoms-causes/syc-20356104

  Bladder cancer is almost always one certain type of cancer called urothelial carcinoma, because it starts when urothelial cells that line the inside of the bladder over multiply and become abnormal. […] To determine if you have bladder cancer, your doctor may start with a cystoscopy, where a tiny camera is passed through the urethra to see into the bladder. If your doctor finds something suspicious, they can take a biopsy or a cell sample that is sent to a lab for analysis. […] Most bladder cancers are diagnosed at an early stage, when the cancer is highly treatable. But even early-stage bladder cancers can come back after successful treatment. For this reason, people with bladder cancer typically need follow-up tests for years after treatment to look for bladder cancer that recurs.

• #2 Bladder Cancer: Diagnosis and Treatment – PubMed

  https://pubmed.ncbi.nlm.nih.gov/29094888/

  Bladder cancer is the sixth most prevalent malignancy in the United States and causes more than 16,000 deaths annually. The most common clinical presentation is asymptomatic hematuria, which should prompt evaluation with cystoscopy, renal function testing, and upper urinary tract imaging in adults 35 years and older and in those with irritative voiding symptoms, risk factors for bladder cancer, or gross hematuria at any age. […] Transurethral resection of the bladder tumor allows for definitive diagnosis, staging, and primary treatment. Non-muscle-invasive disease is treated with transurethral resection, most often followed by intravesical bacille Calmette-Gurin or intravesical chemotherapy. […] Bladder cancer that invades the muscle layer is typically treated with radical cystectomy and neoadjuvant chemotherapy because of higher rates of progression and recurrence. […] No major organization recommends screening asymptomatic adults for bladder cancer, and the U.S. Preventive Services Task Force concluded that current evidence is insufficient to assess the balance of benefits and harms of screening.

• #2 Diagnosis of bladder cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/bladder/diagnosis

  Diagnosis is the process of finding out the cause of a health problem. Diagnosing bladder cancer usually begins with a visit to your family doctor. Your doctor will ask you about any symptoms you have and may do a physical exam. Based on this information, your doctor may refer you to a specialist or order tests to check for bladder cancer or other health problems. […] The following tests are usually used to rule out or diagnose bladder cancer. Many of the same tests used to diagnose cancer are used to find out how far the cancer has spread (the stage). Your doctor may also order other tests to check your general health and to help plan your treatment. […] A physical exam allows your doctor to look for any signs of bladder cancer. During a physical exam, your doctor may do a pelvic exam or a digital rectal exam (DRE).

• #2 Bladder Cancer: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/14326-bladder-cancer

  Bladder cancer is a relatively rare form of cancer that starts in the lining of your bladder. […] Healthcare providers do a series of tests to diagnose bladder cancer, including: […] Cystoscopy: This is the primary test to identify and diagnose bladder cancer. For this test, providers use a pencil-sized lighted tube called a cystoscope to view the inside of your bladder and urethra. […] If urinalysis, cytology and cystoscopy results show you have bladder cancer, healthcare providers then do tests to learn more about the cancer, including: […] Bladder cancer can be either early stage (confined to the lining of your bladder) or invasive (penetrating your bladder wall and possibly spreading to nearby organs or lymph nodes). […] The stages range from TA (confined to the internal lining of your bladder) to IV (most invasive).

• #2 Diagnosis of bladder cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/bladder/diagnosis

  A urinalysis examines your urine. It finds and measures substances in a sample of urine, such as blood, bacteria and cells. It is often one of the first tests done to check for abnormalities in the urine and problems in the urinary tract. […] Urine cytology studies the cells in a urine sample or bladder washings (collected during a cystoscopy when the bladder is rinsed with salt water). Urine cytology can be used to look for abnormal cells, including bladder cancer cells. […] A cystoscopy uses a thin tube with a light and lens on the end (called a cystoscope) to look inside the bladder and urethra. It is used to look for any tumours or abnormal areas. Biopsy samples and salt water rinses from the bladder (bladder washings) may be taken during a cystoscopy. A cystoscopy is usually done when there is blood or abnormal cells in the urine.

• #2 Bladder Cancer Diagnosis and Follow-Up: The Current Status and Possible Role of Extracellular Vesicles

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6412916/

  Diagnostic methods currently used for bladder cancer are cystoscopy and urine cytology. Cystoscopy is an invasive tool and has low sensitivity for carcinoma in situ. Urine cytology is non-invasive, is a low-cost method, and has a high specificity but low sensitivity for low-grade urothelial tumors. Despite the search for urinary biomarkers for the early and non-invasive detection of bladder cancer, no biomarkers are used at the present in daily clinical practice. […] Current diagnostic tools to detect bladder cancer are cystoscopy and cytology. Cystoscopy is an effective but invasive tool to detect bladder cancer tumors. Moreover, it has a low sensitivity for carcinoma in situ (Tis) and tumors can still be missed because effectiveness is operator-dependent, especially for the detection of recurrence. Sensitivity and specificity range from 62 to 84% and 43 to 98%, respectively, depending on the type, stage, and grading of the tumor.

• #2 Urine Tumor Markers in Bladder Cancer Diagnosis: Overview of Urine Tumor Markers, Genetic Aberrations in Bladder Cancer, Fluorescence In Situ Hybridization

  https://emedicine.medscape.com/article/1953022-overview

  More than 30 urinary biomarkers have been reported for use in bladder cancer diagnosis, but only a few are commercially available; the remainder are still being tested. In addition to urine cytology, tests approved or cleared for marketing by the US Food and Drug Administration (FDA) for bladder cancer diagnosis and/or surveillance include the following: BTA stat: Bladder tumor antigen point of care immunoassay, BTA TRAK: Reference laboratory immunoassay, Cxbladder: Measures the expression of 5 genes (MDK, HOXA13, CDC2, IGFBP5, CXCR2), NMP22 BladderChek: Nuclear matrix protein22 point of care qualitative immunoassay, NMP22 Bladder Cancer Test: In vitro quantitative enzyme-linked immunosorbent assay (ELISA), uCyt+ (formerly ImmunoCyt): Fluorescent monoclonal antibodies against M344, LDQ10, and 19A211, Vysis UroVysion: Fluorescence in situ hybridization (FISH) probe set, Xpert Bladder Cancer Monitor: Measures mRNA (ABL1, CRH, IGF2, UPK1B, ANXA10) in voided urine by reverse transcription polymerase chain reaction (RT-PCR).

• #2 Detecting Bladder Cancer with a Urine Test | Cxbladder

  https://www.cxbladder.com/us/patients/bladder-cancer-faqs/detection/urine-test-detection/

  Urine testing can assist in diagnosing many different disorders including kidney disease, diabetes, liver disorders, urinary tract infections (UTIs), and bladder cancer. […] Abnormal findings in a urine test can be characteristic of certain disease processes. […] In recent years there has been increasing use of molecular diagnostic tests to detect specific proteins or nucleic acids (RNA or DNA) in urine to diagnose diseases such as UTIs, prostatitis, or bladder cancer. […] Several types of urine test have an important role in the overall process of diagnosing bladder cancer. Among these tests, urine cytology and urine tumor marker tests are used to detect the presence or absence of bladder cancer. […] Notably, no single test is best able to detect bladder cancer, and usually different types of tests (i.e., urine tests, cystoscopy, and imaging techniques) are used in combination.

• #2 Bladder Cancer Diagnosis – NCI

  https://www.cancer.gov/types/bladder/diagnosis

  If you have symptoms or lab test results that suggest bladder cancer, your doctor will need to find out if theyre due to cancer or another condition. […] Depending on your symptoms, medical history, and results of your urine lab tests and physical exam, your doctor may recommend more tests to find out if you have bladder cancer, and if so, its extent (stage). […] The following tests and procedures are used to diagnose bladder cancer. […] Cystoscopy is a procedure in which the doctor looks inside the bladder and urethra (the tube that carries urine out of your body) to check for abnormal areas. […] A biopsy is usually done during a cystoscopy procedure. […] CT urogram is a test that takes a CT scan of the urinary tract using a contrast dye injected into a vein. […] IVP is an x-ray imaging test of your urinary tract.

• #2 Bladder Cancer: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1015/p507.html

  The initial evaluation of a patient with suspected bladder cancer relies on cystoscopy, assessment of renal function, and imaging of the upper urinary tract, preferably with computed tomography (CT) urography. […] Urine cytology is not recommended as part of the routine evaluation for asymptomatic microscopic hematuria because renal calculi and urinary tract infections can lead to false-positive results. […] Patients with abnormal findings on bladder wash cytology or tissue pathology should undergo transurethral resection of the bladder tumor (TURBT). This procedure provides essential histopathologic information necessary for definitive diagnosis, staging, and grading, and allows for removal of visible tumor and sampling of surrounding muscle to assess depth. […] No major organizations recommend screening for bladder cancer in asymptomatic adults. In 2011, the U.S. Preventive Services Task Force concluded that there was insufficient evidence to assess the balance of benefits and harms of screening for bladder cancer in asymptomatic adults, a statement endorsed by the American Academy of Family Physicians.

• #2 Patient education: Bladder cancer diagnosis and staging (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bladder-cancer-diagnosis-and-staging-beyond-the-basics/print

  Imaging tests can help to detect any masses or abnormalities in the kidneys, ureters, bladder, or urethra. […] Cystoscopy, also called cystourethroscopy, is a procedure that is done to examine the lining of the urethra and bladder. […] If abnormal tissue is seen, a biopsy can be taken. Biopsies may be done in the office or in the operating room. The biopsy specimen(s) is examined with a microscope to determine if cancerous cells are present. […] After the diagnosis of bladder cancer is confirmed, one or more tests may be performed to stage the disease. […] The most commonly used system for staging is the TNM system (Tumor, Node, Metastasis). […] A cancer’s grade refers to how the cancer cells appear under the microscope. Grade is one factor used to predict how likely the cancer is to recur after treatment and, ultimately, the person’s chance of surviving his or her cancer.

• #2 Bladder Cancer Diagnosis | The University of Kansas Cancer Center

  https://www.kucancercenter.org/cancer/cancer-types/bladder-cancer/bladder-cancer-diagnosis-screening

  A biopsy can be taken through the cystoscope. […] Our specialists use a revolutionary diagnostic and treatment approach called Blue Light Cystoscopy with Cysview that improves detection and removal of early-stage bladder cancer with greater accuracy and helps reduce recurrence. […] When symptoms and blood tests suggest bladder cancer, physicians visually inspect the interior wall of the bladder using a cystoscope in a procedure called a cystoscopy. […] With BLC, physicians use a cystoscope equipped with both white and blue light after administering an optical-imaging drug that cancer cells absorb. […] This drug makes the cancer cells glow bright fluorescent pink in blue light and stand out against the healthy tissue so they’re easier to find. […] Your doctor may use BLC in certain situations, such as:

• #2 Bladder Cancer Diagnosis | The University of Kansas Cancer Center

  https://www.kucancercenter.org/cancer/cancer-types/bladder-cancer/bladder-cancer-diagnosis-screening

  If bloodwork indicates presence of cancer cells and white light cystoscopy is negative. […] In assessing bladder cancer tumors. […] During a trans urethral resection of a bladder tumor the surgeon removes the tumor in your bladder through the urethra, the tube that carries urine from the bladder to the outside of your body. […] This allows your physician to stage and grade your tumor. […] You may have additional blood tests to confirm a diagnosis of bladder cancer.

• #2 Bladder Cancer Diagnosis – NCI

  https://www.cancer.gov/types/bladder/diagnosis

  Urinary tumor markers are substances found in the urine that are either made by bladder cancer cells or that the body makes in response to bladder cancer. […] If youre diagnosed with bladder cancer, you will be referred to a urologic oncologist. […] The process of learning the extent of cancer in the body is called staging. […] A CT scan uses a computer linked to an x-ray machine to make a series of detailed x-ray pictures of areas inside the body from different angles. […] MRI uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body, such as the bladder. […] A chest x-ray is an x-ray of the organs and bones inside the chest. […] A bone scan is a procedure that checks to see if there are rapidly dividing cells, such as cancer cells, in the bone. […] Some people may want to get a second opinion to confirm their bladder cancer diagnosis and treatment plan.

• #2 Diagnosis of bladder cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/bladder/diagnosis

  Magnetic resonance imaging (MRI) uses powerful magnetic forces and radiofrequency waves to make cross-sectional images of organs, tissues, bones and blood vessels. An MRI may be used to check if bladder cancer has spread to organs or areas outside the bladder. […] An ultrasound uses high-frequency sound waves to make images of parts of the body. It may be used to check if bladder cancer has spread to other organs or areas in the pelvis and abdomen. […] A bone scan uses bone-seeking radioactive materials called radiopharmaceuticals and a computer to create a picture of the bones. It is used to check if bladder cancer has spread to bone.

• #2 EAU Guidelines on Non-muscle-invasive Bladder Cancer – Uroweb

  https://uroweb.org/guidelines/non-muscle-invasive-bladder-cancer/chapter/diagnosis

  A focused patient history is mandatory. […] Haematuria is the most common finding in NMIBC. Visible haematuria was found to be associated with higher stage at diagnosis disease compared to nonvisible haematuria. Carcinoma in situ might be suspected in patients with lower urinary tract symptoms, especially irritative voiding symptoms. […] A focused urological examination is mandatory although it does not reveal NMIBC. […] Computed tomography (CT) urography is used to detect papillary tumours in the urinary tract, indicated by filling defects and/or hydronephrosis. […] Intravenous urography (IVU) is an alternative if CT is not available, but CT urography provides more information particularly in muscle-invasive tumours of the bladder and in UTUCs (including status of lymph nodes and neighbouring organs).

• #2 Bladder Cancer: Tests After Diagnosis | University Hospitals

  https://www.uhhospitals.org/health-information/health-and-wellness-library/article/adult-diseases-and-conditions-v0/bladder-cancer

  MRI might be used to look for cancer that’s spread outside your bladder. […] A bone scan may be done if your healthcare provider thinks the cancer may have spread to your bones based on your symptoms and the results of other tests. […] This X-ray may be done to see if there are any changes in your lungs. It may show that the bladder cancer has spread to your lungs or chest.

• #2 Patient education: Bladder cancer diagnosis and staging (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bladder-cancer-diagnosis-and-staging-beyond-the-basics

  Imaging tests can help to detect any masses or abnormalities in the kidneys, ureters, bladder, or urethra. […] Cystoscopy, also called cystourethroscopy, is a procedure that is done to examine the lining of the urethra and bladder. […] If abnormal tissue is seen, a biopsy can be taken. Biopsies may be done in the office or in the operating room. The biopsy specimen(s) is examined with a microscope to determine if cancerous cells are present. […] After the diagnosis of bladder cancer is confirmed, one or more tests may be performed to stage the disease. […] The most commonly used system for staging is the TNM system (Tumor, Node, Metastasis). […] A cancer’s grade refers to how the cancer cells appear under the microscope. Grade is one factor used to predict how likely the cancer is to recur after treatment and, ultimately, the person’s chance of surviving his or her cancer. […] Several factors are used to describe a bladder cancer as low, intermediate, or high risk based upon the likelihood of cancer recurrence and progressions.

• #2 Bladder Cancer Diagnosis and Follow-Up: The Current Status and Possible Role of Extracellular Vesicles

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6412916/

  Urine cytology is a non-invasive diagnostic method used in clinical practice where voided or instrumented urine is examined for exfoliated cancer cells. The overall sensitivity ranges from 28 to 100%, with a median of 44%. It has a high sensitivity for high-grade tumors, but low sensitivity for low-grade tumors, ranging only from 4% to 31%. […] The FDA-approved tests have not replaced the current diagnostic standards of urine cytology and cystoscopy. In order to improve bladder cancer diagnosis, extensive research is being carried out in the search for sensitive and specific biomarkers. […] The sensitivity of most of these tests increases with higher tumor stage or grade. In some tests, false positives are seen due to inflammation and hematuria, for example. This hampers the diagnosis of recurrences.

• #2 Biomarkers for Bladder Cancer Diagnosis and Surveillance: A Comprehensive Review

  https://www.mdpi.com/2075-4418/10/1/39

  From the FDA-approved tests, urinary cytology, nuclear matrix protein 22 (NMP22) kit, NMP22 BladderChek Test, BTA-TRAK and BTA stat kits, Cell Search, and UroVysion are approved for initial detection and surveillance of BC whereas some tests, such as uCyt+, are only approved for the follow-up of BC. […] Despite not having FDA approval, other tests exist, and some with European Conformity Approval (CE) marking such as Epicheck and Uromonitor, present promising sensitivity and specificity values. […] Overall, BTA stat, ImmunoCyt, and Urovision present higher sensitivity when used as diagnosis and follow-up tools in comparison with urinary cytology but present a lower specificity. […] The Uromonitor test kit (U-Monitor, Porto, Portugal) is a procedure developed and optimized for the detection of hotspot mutations in TERTp and FGFR3 genes in DNA from tumor cells exfoliated to urine in a real-time PCR platform.

• #2 Urine Tumor Markers in Bladder Cancer Diagnosis: Overview of Urine Tumor Markers, Genetic Aberrations in Bladder Cancer, Fluorescence In Situ Hybridization

  https://emedicine.medscape.com/article/1953022-overview

  Overall, genetic urinary biomarkers are a very heterogeneous group of tests that currently cannot replace cystoscopy and cytology, which remain the gold standard for surveillance of nonmuscle-invasive bladder cancer (NMIBC). Although there are some ongoing clinical trials comparing both approaches, there is no level 1 evidence to support biomarker use instead of the gold standard. A systematic review and network meta-analysis of novel urinary biomarkers for NMIBC supported the use of these tests for diagnosing recurrence during follow-up of NMIBC but found insufficient data to support their use for initial diagnosis of NMIBC. […] Several reviews have been performed to assess the myriad urine markers proposed for bladder cancer surveillance. They note that none of the markers has been proven sensitive and specific enough to replace cystoscopy. While commercially available urinary markers are promising, the clinical evidence is insufficient to warrant the substitution of the cystoscopic follow-up scheme with any of the currently available urine marker tests.

• #3 Bladder Cancer Diagnosis and Follow-Up: The Current Status and Possible Role of Extracellular Vesicles

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6412916/

  Urine cytology is a non-invasive diagnostic method used in clinical practice where voided or instrumented urine is examined for exfoliated cancer cells. The overall sensitivity ranges from 28 to 100%, with a median of 44%. It has a high sensitivity for high-grade tumors, but low sensitivity for low-grade tumors, ranging only from 4% to 31%. […] The FDA-approved tests have not replaced the current diagnostic standards of urine cytology and cystoscopy. In order to improve bladder cancer diagnosis, extensive research is being carried out in the search for sensitive and specific biomarkers. […] The sensitivity of most of these tests increases with higher tumor stage or grade. In some tests, false positives are seen due to inflammation and hematuria, for example. This hampers the diagnosis of recurrences.

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