Bladder Cancer in Men - Symptoms and Diagnosis

Symptoms of bladder cancer

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  • Blood in the urine (slightly rusty to bright red in color)
  • Frequent urination
  • Pain during urination
  • Lower back pain

Diagnosing bladder cancer

  • Physical exam and health history
  • Urinalysis
  • Internal exam: the doctor inserts gloved fingers into the rectum to feel for lumps
  • Urine cytology: examination of urine under a microscope to check for abnormal cells
  • Cystoscopy: a procedure to look inside the bladder and urethra to check for abnormal areas and possibly remove tissue samples to be checked under a microscope for signs of cancer
  • CT urogram: a CT scan with and without contrast
  • Biopsy: your doctor removes cells or tissues so they can be viewed under a microscope to check for signs of cancer. A biopsy for bladder cancer is usually done during cystoscopy. It may be possible to remove the entire tumor during biopsy.

Staging bladder cancer

After bladder cancer has been diagnosed, tests are done to find out if cancer cells have spread within the bladder lining and muscle or to other parts of your body. Treatment often depends on the stage of the cancer, which is based on diagnostic tests including CT scan of the chest, abdomen and pelvis, MRI, chest X-ray and bone scan.

  • Stage 0 (papillary carcinoma and carcinoma in situ): abnormal cells are found in the tissue lining the inside of the bladder. 
  • Stage I: cancer has spread to the layer of connective tissue next to the inner lining of the bladder.
  • Stage II: cancer has spread to the layers of muscle tissue of the bladder.
  • Stage III: cancer has spread from the bladder to the layer of fat surrounding it. It may also have spread to the prostate and/or seminal vesicles.
  • Stage IV: cancer has spread from the bladder to the wall of the abdomen or pelvis, one or more lymph nodes, and/or other parts of the body such as the lung, liver or bone.