Bladder cancer - European Society for Medical Oncology

3.
4.
In specific circumstances, the doctor will also inspect the ureters, a procedure called
ureteroscopy*. In other circumstances, cystoscopy also includes biopsy sampling from the
urethra*.
Histopathological examination*
This is the laboratory investigation of the tumor cells. It is
performed on the tissue from the tumor removed during
cystoscopy*. The histopathological* information will confirm
the diagnosis of bladder cancer and will reveal the specific
characteristics of the tumor, allowing the doctor to determine
the type of bladder cancer.
If surgery is indicated after the cystoscopy (usually a TURB* ), a second histopathological
examination will be performed on the tumor tissue obtained during surgery. This is very
important to confirm the results of the first biopsy* and to provide more accurate
information on the cancer and the cancer’s stage.
Radiological examination*
If the histopathological examination* shows that
the tumor has grown into the deeper layers (the
muscle layers) of the bladder,
then radiological
investigation is needed to determine if the tumor
has also grown into the tissues and lymph nodes*
outside the bladder.
The radiological investigation is part of a
diagnostic process called staging* and can be
performed using computed
tomography (CT)* or
magnetic resonance imaging (MRI)* of the abdomen and pelvis. The staging procedure
further also includes a CT of the chest, and if there are symptoms of tumor spread in the
bones, also a bone scintigraphy*.
Bladder cancer: a guide for patients‐ Information based on ESMO Clinical Practice Guidelines ‐v.2012.1 Page 8
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