Your doctor will review your medical history. He or she will ask about any history of kidney stones or urinary tract infections. These conditions can also cause blood in the urine. Your doctor will ask about your occupation and your diet.
Your doctor will ask about your history of cigarette smoking. If you don't smoke now, but did in the past, tell your doctor. Your risk of bladder cancer remains high for more than 10 years after your last cigarette.
After reviewing your symptoms and risk factors, your doctor will examine you. The exam will include a rectal examination. Women will also have a pelvic examination.
Your doctor will order laboratory tests. These will include urine and blood tests. The urine sample will be checked for the presence of red blood cells and to rule out an infection. The blood test is used primarily to make sure your kidneys are functioning normally. Your doctor may also send the urine sample to a special lab to look for cancer cells.
The main test when looking for bladder cancer is cystoscopy. Your doctor inserts a medical instrument (called a cystoscope) through your urethra into your bladder. Your urethra is the opening through which you urinate. Your doctor will look inside your bladder to see if there are tumors.
If there are areas of the bladder lining that appear abnormal, your doctor will take one or more biopsies through the cystoscope. This involves cutting out a small piece of tissue. It can then be examined under a microscope to look for cancer cells. If possible, your doctor will remove the entire tumor during cystoscopy.
Additional tests may be needed to determine if the cancer has spread.