How is bladder cancer diagnosed?

Written by Guan Hai Fang
Urology
Updated on September 23, 2024
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Firstly, imaging examinations such as ultrasound can be conducted, which if reveal tumors larger than 0.5 cm can serve as an initial screening for patients; IVU (Intravenous Urography) can show larger tumors as filling defects. Cystoscopy can also be performed by inserting a cystoscope to directly examine the bladder's shape, size, etc. If it appears round, with clear boundaries and without erosion, it is generally benign; if it has a cauliflower-like or seaweed-like appearance, it is generally malignant bladder cancer. Urine tests can also be conducted; cells from tumors found in fresh urine can lead to cytological examination of urine as an initial screening. Additionally, if conditions permit, a physical examination including a bimanual examination of the bladder can be done to preliminarily assess the tumor's size, the extent of invasion, depth, and its relationship with the pelvic wall.

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Early symptoms of bladder cancer

Hematuria is the most common and earliest symptom of bladder cancer, with 85% of patients experiencing intermittent gross hematuria which can decrease or stop on its own, often giving patients a false impression of improvement or cure, thus delaying treatment. Sometimes, hematuria is also found under a microscope, and the amount of bleeding is not necessarily consistent with the size, number, or malignancy of the tumor. The hematuria from bladder tumors can initially be mild, and other symptoms such as frequent urination, urgency, and painful urination may also occur; these are all manifestations of bladder tumors.

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Is the bladder cancer embryonic antigen high?

Carcinoembryonic antigen (CEA) is significantly elevated, mainly seen in gastrointestinal tumors, especially in colorectal cancers such as colon and rectal cancers, where CEA elevation is more pronounced. It can also be notably higher in patients with lung adenocarcinoma, and bladder cancer might show an increase in CEA as well. However, the increase in CEA is not necessarily consistent, and its diagnostic value for bladder cancer is limited due to low specificity and sensitivity, making it not very instructive. The definitive diagnosis of bladder cancer primarily involves cystoscopy and taking a biopsy to confirm the presence of cancer.

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What medicine is infused into the bladder for bladder cancer?

Postoperative intravesical chemotherapy infusion is very common in the treatment of bladder cancer. Common drugs used for infusion chemotherapy include mitomycin and anthracyclines such as epirubicin or pirarubicin. Gemcitabine is also frequently used for this purpose. The related side effects generally include irritation symptoms of the bladder, although some patients may experience relatively mild side effects.

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The difference between bladder tumor and bladder cancer is that a bladder tumor may be benign or malignant, whereas bladder cancer specifically refers to a malignant tumor.

The difference between bladder tumors and bladder cancer generally lies in whether the growth inside the bladder is benign or malignant. Normally, nothing should grow inside the bladder. However, if a growth does appear, it can be referred to as a bladder tumor if it is benign, or bladder cancer if it is malignant. Bladder tumors are typically round with clear boundaries, which can be observed through ultrasound or cystoscopy. On the other hand, if the growth in the bladder resembles seaweed or cauliflower, with unclear boundaries, erosion, bleeding, or other symptoms, it can be referred to as bladder cancer. Generally, the primary treatment for such cases is surgical removal.

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Can urine odor be a sign of bladder cancer?

Urine with an unusual odor may be caused by bladder cancer, but the presence of an odor alone cannot be used to diagnose bladder cancer. Clinically, urine with an odor is commonly associated with urinary tract infections, as patients with such infections tend to have a higher amount of inflammatory secretions in their urine. Additionally, patients with urinary tract infections may lose some body water through sweating, leading to more concentrated urine, which can increase the odor. Bladder cancer patients are more susceptible to urinary tract infections, so they may also experience odorous urine. Clinically, bladder cancer is diagnosed through a combination of the patient's symptoms and supportive diagnostic tests. In the early stages of the disease, bladder cancer typically presents as painless hematuria (blood in the urine) that persists for an extended period. A routine urinalysis can be performed to check for elevated red blood cells in the urine. If bladder cancer is suspected, a cystoscopy can be conducted to identify any masses in the bladder and take biopsy samples for pathological examination. The presence of tumor cells in these samples generally confirms a diagnosis of bladder cancer.