Insights on Bladder Cancer Detection

May 12, 2023, 12:34 PM by Faculty Group Practice Newsletter

Bladder Cancer Awareness Day is observed annually on May 7. On the day, awareness programs are organized to educate the public about the symptoms, causes, and treatment of this type of cancer. According to the American Cancer Society, it is estimated there will be 82,290 new cases of bladder cancer in the United States in 2023, with 16,710 estimated new deaths.

Chelsie Chonoski, MSN, APRN, FNP-C, a nurse practitioner in the Division of Urology, is delighted to share her knowledge of bladder cancer detection.

Currently there is a not a recommendation of routine bladder cancer screening for the general public. Bladder cancer is usually detected during evaluation for hematuria or irritative lower urinary tract symptoms. Hematuria is one of the most common signs of bladder cancer, although can also be from a benign etiology. Individuals with gross and microscopic hematuria or persistent irritative urinary symptoms should have evaluation by Urology. Microscopic hematuria is defined by the American Urologic Association as 3 or more red blood cells (RBC)/high-power field (HPF) on a properly collected urinalysis. Urology evaluation will include medical history, physical exam, imaging according to risk stratification, and cystoscopy.

As stated by the American Urologic Association, bladder cancer risk factors include increased age, male sex, tobacco use, persistent microscopic hematuria, history of gross hematuria, irritative lower urinary tract symptoms, prior pelvic radiation therapy, family history of urothelial cancer, occupational exposures to benzene chemicals or aromatic amines, prior cyclophosphamide/ifosfamide chemotherapy and chronic indwelling foreign body in the urinary tract.

Urine cytology testing is available and can detect cancer but is not reliable enough to use as a good screening test. Cystoscopy is a procedure usually performed in the clinic with local sedation where a cystoscope is passed in the urethra and visualizes the inside of the bladder to detect if a bladder lesion or mass is present. If a mass or lesion is detected, the patient is scheduled for an outpatient transurethral resection of bladder tumor (TURBT) to remove the mass/lesion and send for pathology for diagnosis confirmation.

Bladder cancer treatment depends on the grade and invasiveness, non-muscle invasive bladder cancer (NMIBC) or muscle invasive bladder cancer (MIBC), as well as patient general health and age. After bladder cancer treatment these patients will require ongoing evaluation with cystoscopy to assess for recurrence.


View Chelsie Chonoski’s patient care profile here