The most common symptom is blood in the urine, known as HAEMATURIA. This may appear suddenly with no apparent cause, and there is unlikely to be any pain associated with it. The urine may vary from rusty brown to deep red, depending on the amount of blood. It may be present some days and not others, and may disappear for weeks or months. The amount of blood is not related to the extent of the cancer. Sometimes blood clots can form and cause pain or obstruction to the flow of urine.It should be remembered that there are other, more likely reasons why you might have haematuria, such as an infection in your bladder, or kidney stones. It does NOT necessarily indicate bladder cancer. It is, however, important to have it checked by your GP as soon as possible so that a diagnosis can be made and appropriate treatment started.Normally, the first person you will see will be your own family doctor. You will be asked for a urine sample to test for blood and infection. You will also probably be examined, including an internal examination of the back passage (RECTUM) in men, and birth canal (VAGINA) in women.Depending on the results of the examinations your GP may then refer you to a bladder specialist (UROLOGIST) at the hospital, who will want you to have further tests to determine whether you do have cancer, and if so, its exact type and extent. The most effective treatment can then be discussed with you.BLOOD TESTS will give the doctor an indication of your general health and how well your kidneys are working.A CHEST-XRAY will examine your heart and lungs to check that they are healthy.INTRAVENOUS UROGRAM or PYELOGRAM (IVU or IVP) is an X-ray examination that looks at your kidneys, ureters and bladder. The doctor can recognise on the X-ray film any abnormalities in the outline of the urinary system.The IVU is carried out in the X-ray department, takes about an hour, and you can normally go home immediately afterwards. The injection of dye may make you feel hot and flushed initially but this soon passes. CYSTOSCOPY is a telescopic examination that allows the urologist to inspect the inside of your bladder. Using the flexible cystoscope the examination is not painful, and does not require a general anaesthefic, so you you may return home afterwards. Under some circumstances it may be recommended that you have a general anaesthetic, for example if issue samples (BIOPSIES) need to be taken.Biopsies are examined under a microscope to establish whether there are any cancerous cells, and if so, what kind they are.They can be completely removed very simply by cutting them off with a probe passed up the cystoscope and CAUTERISING the bladder wall to prevent bleeding. The tumours are then removed through the cystoscope for microscopic examination. Small tumours are destroyed completely by this treatment but unfortunately the bladder may develop other tumours with time. It is therefore very important to have regular cystoscopies every few months to check that the bladder remains healthy and tumour free. Your urologist will be able to discuss with you how often you will need to come to hospital for cystoscopies once he has looked at your bladder and seen the laboratory result from your biopsies.Surgery, radiotherapy and chemotherapy can be used alone or in combination to treat invasive bladder cancer. The treatment is planned and discussed with each individual patient, taking into account your age, general health, type and size of tumour and where it has spread, if at all.Hope this was helpful for you :-)
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