Greater Boston Urology Blog

How is Bladder Cancer Diagnosed and Treated?

In his own words, Dr. James M. Fitzgerald discusses how bladder cancer is diagnosed and treated. You can also watch the video—he discusses everything at the 1:25 mark. (We've lightly edited the transcript for readability.) 

As with all content on Greater Boston Urology's blog, the following information is educational in nature, not medical advice. Always talk to your physician about your specific health care questions and conditions.

[Editor's note: This article was reviewed and updated with additional links on January 17, 2022.]

"Bladder cancer affects both men and women. It's actually the fourth most common cancer in men. It's less common in women, but is still a significant problem for women.

The number one risk factor for bladder cancer is cigarette smoking, just like it is for lung cancer. Usually, a primary care physician will see a patient who either sees visible blood in his or her urine or who is found to have blood on a urine test—microscopic blood. Then they're referred to a urologist.

There are many different causes for blood in the urine and bladder cancer is just one of them. The test that we use to diagnose bladder cancer is called a cystoscopy, which is a test that we do in the office.

We look into the bladder with a small telescope using local anesthesia. Once a bladder tumor has been detected, the way it's initially treated is usually an outpatient procedure in an operating room called a TURBT, or transurethral resection of bladder tumor.

We look into the bladder with a scope and actually shave the tumor from the bladder wall and remove it. Further therapy for bladder cancer is generally based on the pathology. How aggressive is the cancer and what is the stage? The stage is usually determined by whether the tumor is invasive into the muscle of the bladder or not.

Subsequent treatment can involve anything from just simply surveillance where we look in the bladder periodically to medications that we instill into the bladder in the office. And much less commonly, patients will need more aggressive therapy like more aggressive surgery to include removal of the bladder, and occasionally radiation and/or chemotherapy."



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