Medical History & Physical Exam
Reviewed by: HU Medical Review Board | Last review date: September 2017. | Last updated: October 2020
The process of diagnosing bladder cancer often begins when the patient visits a primary healthcare provider.1,2 Patients may visit their healthcare provider because they have experienced symptoms that the healthcare provider recognizes as possible signs of bladder cancer—such as blood in the urine, for example, or other types of changes or problems related to urination. In other cases, the results of laboratory tests carried out by the healthcare provider during a regular check-up may be the first sign that the patient may have bladder cancer. The first steps are for the healthcare provider to learn more about the patient’s symptoms, medical history, and possible risk factors for bladder cancer, and then to carry out a physical examination.
A medical history helps doctors learn more about the patient
The purpose of a taking a patient’s medical history is for the healthcare provider to learn more about the patient’s symptoms and about any other health conditions the patient has had in the past or is being treated for now.1,2 The healthcare provider will also learn about the patient’s general health and lifestyle habits.
Assessing risk factors in a person's medical history
The healthcare provider will also assess for any risk factors the patient has, which can make a person more likely to develop bladder cancer. For example, people who smoke or use tobacco products are much more likely to develop bladder cancer than those who do not. People who work in certain professions where they are exposed to toxic substances also have a higher risk of bladder cancer. The medical history of your family also provides useful information, especially if anyone in your family has had bladder cancer.
The physical exam
During the physical exam, the healthcare provider checks the patient’s body for signs and symptoms of bladder cancer or any other condition that may be causing symptoms.1,2 Healthcare providers will often carry out an internal exam on the patient, because in some cases it is possible to feel a bladder tumor inside the body.
For both men and women, the internal exam will often include a digital rectal exam. The healthcare provider uses a gloved and lubricated finger to examine the inside of the patient’s rectum to feel for any physical signs of cancer.
Women may receive a pelvic examination as part of the physical exam. This allows the healthcare provider to examine the inside of the vagina to check if there are any signs of tumors.
Providing a urine sample
During the patient’s visit, the healthcare provider may ask the patient for a urine sample to be analyzed in the laboratory.1,2 Common types of urine lab tests include urinalysis, urine cytology, urine culture, or urine tumor marker tests.
Other tests that help diagnose bladder cancer
The healthcare provider may decide to order further testing based on the results of the patient’s symptoms, medical history, physical examination, and urine lab tests. These tests are used to help diagnose or rule out bladder cancer as the cause of the patient’s symptoms. These types of diagnostic tests can include:
- Examination under anesthesia
- Cystoscopy and fluorescence cystoscopy
- Transurethral resection of bladder tumor (TURBT)
- Imaging tests, including pyelogram, CT/CAT scan, MRI, or ultrasound