Screening for Bladder Cancer
Screening is the use of tests or exams to look for a disease in people who have no symptoms. At this time, no major professional organizations recommend routine screening of the general public for bladder cancer. This is because no screening test has been shown to lower the risk of dying from bladder cancer in people who are at average risk.
Some doctors may recommend bladder cancer screening for people at very high risk, such as:
- People who had bladder cancer before
- People who had certain birth defects of the bladder
- People exposed to certain chemicals at work
Tests that Might Be Used to Screen for Bladder Cancer
Screening tests for bladder cancer look for different substances or cancer cells in the urine.
Urinalysis: One way to test for bladder cancer is to check for blood in the urine (called hematuria). This can be done during a urinalysis, which is a simple test to check for blood and other substances in a sample of urine. This test is sometimes done during a general health checkup.
Blood in the urine is usually caused by benign (non-cancerous) conditions such as infections, but it also can be the first sign of bladder cancer. Large amounts of blood in urine can be seen if the urine turns pink or red, but a urinalysis is needed to find small amounts.
Urinalysis can help find some bladder cancers early, but it has not been shown to be useful as a routine screening test.
Urine cytology: In this test, the doctor uses a microscope to look for cancer cells in urine. Urine cytology does find some cancers, but it its not reliable enough to make a good screening test.
Urine tests for tumor markers: Several newer tests look for substances in the urine that might indicate bladder cancer. These include:
- UroVysionTM: This test looks for chromosome changes that are often seen in bladder cancer cells.
- BTA tests: These tests look for a substance called bladder tumor-associated antigen (BTA), also known as CFHrp, in the urine.
- ImmunocytTM: This test looks at cells in the urine for the presence called NMP22 in the urine, which is often found at higher levels in people who have bladder cancer.
These tests might find some bladder cancers early, but they can miss some cancers as well. In other cases, the test result might be abnormal even in some people who do not have cancer. At this time the tests are used mainly to look for bladder cancer in people who already have signs or symptoms of cancer, or in people who have had a bladder cancer removed to check for cancer recurrence. Further research in needed before these or other newer tests are proven useful as screening tests.
Watching for Possible Symptoms of Bladder Cancer
While no screening tests are recommended for people at average risk, bladder cancer can often be found early because it causes blood in the urine or other urinary symptoms. Many of these symptoms often have less serious causes, but it’s important to have them checked by a doctor right away so the cause can be found and treated, if needed. If the symptoms are from bladder cancer, finding it early offers the best chance for successful treatment.
Signs and Symptoms of Bladder Cancer
Bladder cancer can often be found early because it causes blood in the urine or other urinary symptoms.
Blood in the Urine
In most cases, blood in the urine (called hematuria) is the first sign of bladder cancer. Sometimes, there is enough blood to change the color of the urine to orange, pink, or, less often, darker red. Sometimes, the color of the urine is normal but small amounts of blood are found when a urine test (urinalysis0 is done because of other symptoms or as part of a general medical checkup.
Blood may be present one day and absent the next, with the urine remaining clear for weeks or months. If a person has bladder cancer, blood eventually reappears.
Usually, the early stages of bladder cancer cause bleeding but little or no pain or other symptoms.
Blood in the urine does not always mean you have bladder cancer. More often it is caused by other things like infection, benign (non-cancerous) tumors, stones in the kidney or bladder, or other benign kidney diseases. But it’s important to have it checked by a doctor so the cause can be found.
Changes in Bladder Habits or Symptoms of Irritation
Bladder cancer can sometimes cause changes in urination, such as:
- Having to urinate more often than usual
- Pain or burning during urination
- Feeling as if you need to go right away, even when the bladder is not full
- Having trouble urinating or having a weak urine stream
These symptoms are also more likely to be caused by a urinary tract infection (UTI), bladder stones, an overactive bladder, or an enlarged prostate (in men). Still, it’s important to have them checked by a doctor so that the case can be found and treated, if needed.
Symptoms of Advanced Bladder Cancer
Bladder cancers that have grown large enough or have spread to other parts of the body can sometimes cause other symptoms, such as:
- Being unable to urinate
- Lower back pain on one side
- Loss of appetite and weight loss
- Feeling tired or weak
- Swelling in the feet
- Bone pain
Again, many of these symptoms are more likely to be caused by something other than bladder cancer, but it’s important to have them checked so that the cause can be found and treated, if needed.
If there is a reason to suspect you might have bladder cancer, the doctor will use one or more exams or tests to find out if it is cancer or something else.