What tests might I have after being diagnosed?

After a diagnosis of bladder cancer, you will likely need more tests. These tests help your healthcare providers learn more about the cancer. They can help show if it has grown into nearby tissues or spread to other parts of your body. The test results help your healthcare providers work with you to decide the best ways to treat the cancer. If you have any questions about these or other tests, be sure to talk with your healthcare team.

Some of the tests used after diagnosis may include:

• Intravenous pyelogram (IVP)

• Ultrasound

• CT scan

• MRI (magnetic resonance imaging)

• Bone scan

• Chest X-ray

Imaging tests

Intravenous pyelogram (IVP)

For this test, a contrast dye is put into your blood through a vein in your arm or hand. As the dye moves through your blood, it outlines your kidney, ureters, and bladder, and a series of X-rays is taken. Before this test, tell your healthcare provider if you have allergies or have had a reaction to contrast dye in the past.

IVP is used to find tumors, other changes, or blockages. It can show the blood flow through your kidneys. It can also be used to check for spread (metastasis) of the bladder cancer to other parts of the urinary tract.

Ultrasound

This test uses sound waves to make images of the inside of your body. For this test, a technician puts a warm gel on your belly. A small handheld wand (called a transducer) is then moved over your skin. The transducer gives off sound waves and picks up the echoes as they bounce off the tissues. This allows the technician to look at and make pictures of your bladder and nearby organs. Blood flow through nearby blood vessels can also be checked.

Ultrasound can be used to help figure out if the cancer has spread from your bladder to other nearby tissues. It can also be used to look at your kidneys. It's easy to have, doesn't hurt, and uses no radiation.

CT scan

A CT scan uses a series of X-rays to make pictures of the inside of your body from many angles. A CT scan can show detailed images of any part of your body. These include your bones, muscles, fat, blood vessels, lymph nodes, and organs. CT scans are more detailed than regular X-rays.

CT scans can be used to find out the size of the tumor, exactly where it is, and if it has spread to nearby tissues or lymph nodes.

During the test, you lie still on a narrow table as it slides through the center of the ring-shaped CT scanner. Then the scanner sends beams of X-rays at your body. A computer uses the X-rays to create many pictures of the inside of your body. These are put together to create a 3-D picture. You may be asked to hold your breath once or more during the scan. You may be asked to drink a contrast dye after the first set of pictures is taken. This dye can help get clearer images. It will pass out of your body over the next day or so through your bowel movements. If the dye is put into your blood through an IV in your arm, it may cause a feeling of warmth in your body for a few minutes. In rare cases, it can also cause hives or other allergic reactions. Tell the technician if you don’t feel well during the test.

MRI

MRI uses large magnets, radio waves, and a computer to make detailed images of your insides. It’s a lot like a CT scan, but it doesn’t use X-rays. MRI might be used to look for cancer that's spread outside your bladder. A special type of MRI called an MRI urogram can be used instead of IVP to look for cancer in other parts of your urinary tract.

For this test, you’ll lie very still on a narrow table as it passes through a tube-like scanner. The scanner directs a beam of radio waves at the part of your body being scanned. A computer uses the radio waves to create a 3-D picture of your insides. You may need more than 1 set of images. Each set may take 2 to 15 minutes, so the whole scan may take an hour or more. A contrast dye might be put into a vein in your hand or arm before this scan. It helps get even clearer images of the inside of your body. You might be given earplugs because there are loud thumping and buzzing noises during the scan. If you're claustrophobic (uncomfortable in small spaces), you may need to be given a sedative before having this test. Other than the injection of the dye, this test is painless.

Bone scan

A bone scan may be done if your healthcare provider thinks the cancer may have spread to your bones based on your symptoms and the results of other tests. For this test, a mildly radioactive substance is put into your blood through a vein in your hand or arm. It travels through your blood and collects in parts of your bones that are damaged. A machine is then used to scan your whole body. The radioactive areas can be seen on the scans.

Other than the injection, a bone scan is painless. The radioactive substance washes out of your body in your urine over the next few days.

Chest X-ray

This X-ray may be done to see if there are any changes in your lungs. It may show that the bladder cancer has spread to your lungs or chest. An X-ray uses a small amount of radiation to make an image of organs and bones inside your body. It can also show enlarged lymph nodes in your chest.

For the test, you stand in front of a rectangular target area where the X-ray film is held. You may be asked to hold your arms to the side or over your head. You take a breath and stay still for a few seconds. An X-ray will be done from the front and from the side. This test takes a few minutes and doesn’t hurt.

Working with your healthcare provider

Talk with your healthcare provider about which tests you'll need. Get ready for the tests as instructed. Be sure you know what the test will be like and why it's being done. Ask questions and talk about any concerns you have. Also ask when and how you'll get the test results.