Bladder Cancer Diagnosis – Endoscopy, Imaging Techniques and Cytology
When the urologist suspects that the patient has bladder cancer, which is determined by the conversation to the patient’s age, history of blood in the urine and the presence harmful and risk factors, there should be made different diagnostic tests. Their goal is to determine whether there is a tumor or not. If you have a tumor, a necessary information should be gathered – its size, location, incidence and degree of malignancy.
The modern medicine has different methods for better bladder cancer diagnosis will split into three groups – imaging, cytology and endoscopy.
The main tool for bladder cancer diagnosis of suspected tumor in the bladder is cystoscopy. When it is used a tool called a cystoscope, which comprises an optical unit (camera) and a source of light, which penetrates into the bladder through the urethra and directly look around inside and it is made with tenfold optical zoom in the image. This is the gold standard for the diagnosis and according to many doctors presence of blood in the urine means cystoscopy. With its help tumors were detected in 90% of cases.
Besides view of the bladder, cystoscopy can be used for taking a material from the suspicious for cancer area to investigate histologically. That way the diagnosis is 100% certain. The great advantage of cystoscopy is that it can easily go from diagnostic to therapeutic, for example in transurethral resection of the tumor.
Ultrasound is the non-invasive study that can give a good idea of the size of tumor, invasion into the bladder wall, etc. Often this is the first study to which patients are subjected. The disadvantage is that as most imaging, ultrasound can not detect small tumors at an early stage, allowing you optimal treatment.
2. CAT – computerized axial tomography (scanner)
It represents X-ray which gives a detailed picture as to the interior of the bladder, the growth of the tumor in the bladder wall, surrounding tissues, the presence of metastases in the near or – distant organs. Since the scanner still presents some risks of X-ray beam and the load, it is usually performed after ultrasound and can not be used for primary diagnosis of early stages.
3. Magnetic resonance imaging – MRI
Like the scanner, the magnetic resonance imaging gives a detailed picture of the soft tissue in the pelvis, but without using X-ray irradiation. Again, it can not be used for primary diagnosis of early tumors.
4. IVP (color photograph)
Upon insertion of intravenous contrast there are made a series of X-rays. It is displayed filling of kidney, renal pelvis, urethra and bladder. The tumor is portrayed as filling defects. Currently, the method is almost entirely replaced by MRI and CAT.
The method is a urine test to detect cancer cells pared and stuck in urinary flow. It is used more as a supporting study, in addition to cystoscopy than as an independent one.
In summary the diagnostic methods will present routine diagnostic algorithm in a patient with suspected bladder cancer:
– Adults Patient with evidence of blood in the urine.
– Ultrasound with which has been proven the presence of tumor formation in the bladder. A positive result following:
– In Need, but not necessarily – scanner of the urinary system, which adds data from ultrasound and allows for the detection of metastases or involvement of adjacent bladder authorities.
– Cystoscopy and biopsy, and if possible and it allows the stage – transurethral resection of the tumor.
– Histological study of the cut section, which determines the degree of malignancy and extent of the process in depth of the bladder wall.