Diagnosis and Staging

Evaluation. If a patient encounters symptoms such as blood in the urine, a frequent feeling of fullness in the bladder or a constant need to urinate s/he should get a bladder evaluation from a skilled urologist. The Lacks Cancer Center at Saint Mary’s offers a dedicated Urologic Clinic with a variety of specialists and progressive technologies. Here, there are several tests that examine the urine, bladder, kidneys, ureters, vagina or rectum and assist us in pinpointing bladder cancer or cancers of the urinary tract. The specific type of evaluation used is based on individual history and needs.

Evaluations may include:

• Physical Examination-An examination of the back, abdomen and pelvis.
• Urine Cytology-A microscopic assessment of urine to check for abnormal cells.
• Urinalysis-A basic test that evaluates the contents of the urine.
• NMP-22-A urine test using a special chemical that detects the presence of a protein associated with bladder cancer.
• Intravenous Pyelogram (IVP)-A contrast dye is injected into a vein, then as it moves through the urinary tract a series of x-rays are taken—the dye helps highlight any masses or blockages.
• Cystoscopy-Utilizing a cystoscope (a thin, lighted tube) that is inserted through the urethra into the bladder, our urologists can look inside the bladder and urethra to check for abnormal areas, and may take tissue samples for further study.
  

Diagnosis. If your urologic evaluation results are abnormal, further diagnostic testing must be undertaken. Bladder cancer can only be conclusively diagnosed through a biopsy, which consists of removing and microscopically examining a tissue sample from the affected area. Biopsies may be performed in the physician’s office or under anesthesia at The Lacks Cancer Center.

Staging. During tissue evaluation, our pathologist assigns a grade and a stage to the tumor. The grade describes the aggressiveness of the cancer and the stage tells us how deeply it has invaded the bladder and surrounding tissues. The combination of grade and stage gives us the information we need to create a hard line, personalized treatment plan. At The Lacks Cancer Center, we perform Transurethral Resection, a surgical procedure that provides both staging and treatment for many bladder tumors. During this minimally invasive procedure, a cystoscope—a thin, lighted tube with an electrified cutting loop attachment—is inserted into the bladder through the urethra to remove the tumor and some surrounding tissue.

The following tests and procedures may also be used in the staging process:

• CT Scan (CAT scan)-Also known as a Computed Tomography scan, this high-tech computer-linked x-ray machine takes a series of detailed pictures from many different angles, offering thorough images of the affected tissue.
• Magnetic Resonance Imaging (MRI)-A procedure that uses a magnet, radio waves and a computer to make a series of detailed images of the body. These pictures pinpoint diseased tissue.
• Radionuclide Bone Scan-This procedure determines if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein, travels through the bloodstream to collect in the bones and is recorded by a scanner.
  

To schedule a biopsy or advanced diagnostic services from our Multidisciplinay Urologic Clinic simply ask your primary care physician for a referral or make a self-referral by calling 1-877-LACKS-MI.