Screening for both bladder and kidney cancer involves a complete medical history and physical examination, as well as laboratory and imaging tests. The methods of diagnosis for these two cancers are given below.
- Blood and urine tests
- Intravenous pyelogram (IVP): In this test, a series of x-rays and a contrast dye injected into a urethra are used to detect tumors, abnormalities, kidney stones and obstructions, as well as to assess renal blood flow.
- Renal angiography: X-rays and contrast dye are used to detect signs of blockage or abnormalities affecting blood flow to the kidneys.
- Imaging tests: A CT scan, MRI, ultrasound, chest x-ray and/or bone scan may also be used to look for internal abnormalities in the body and detect the presence of tumors.
If your doctor suspects that you have a tumor, he or she may order a biopsy, or a procedure in which a tissue sample is taken and sent off to a lab for analysis.
- Lab tests: Lab tests for bladder cancer may include NMP22®BladderChek®, a urine test that can detect the presence of NMP22®, a nuclear matrix protein that bladder cancer causes to be elevated in the urine, even in early stages. A urinalysis to detect microscopic hematuria and urine cytology to rule out a urinary tract infection may also be used.
- Imaging tests: IVP is the standard imaging test for bladder cancer, as it provides information about the function and structure of the kidneys, ureters and bladder. A CT scan, MRI, x-ray and bone scan may also be used.
- Biopsy: If your doctor suspects bladder cancer, he or she will perform a cystoscopy and biopsy. The cytoscope—a thin, telescope-like tube with a small, attached camera—is inserted into the bladder through the urethra, and allows the doctor to look for potential problems. For the biopsy, the doctor will remove a small amount of bladder tissue and send it off to the lab for analysis.
- Fluorescence in situ hybridization (FISH): This is a newer test that can allow doctors to detect a recurrent bladder tumor even before it is visible. However, more research on this method is needed, and it is not yet a standard test.