Referral

If a GP thinks you have symptoms that could be caused by a urological cancer, they will be referred to a urological cancer consultant for further tests and specialist advice.

Haematuria clinic

If blood is found in a patient’s urine (haematuria), they may be referred to a ‘one-stop’ haematuria clinic within the Trust.

At this clinic, all the tests needed to make a diagnosis can often be carried out on the same day.

Investigations and diagnosis

As part of the pathway for diagnosis and management of a urological cancer, patients may be sent for a number of investigations. These investigations allow doctors to make a diagnosis to see the extent of any disease.

Some investigations are used for all types of urological cancer, while others are used for specific types.

As part of diagnosis and management of urological cancer, a number of investigations may be necessary.

Diagnostic investigations may include:

  • Cystoscopy – medical procedure used to examine the inside of the bladder using an instrument called a cystoscope
  • Ultrasound – a test that uses sound waves to examine the bladder, kidneys, testicles or prostate
  • Prostate Specific Antigen (PSA) Test – a blood test that measures the total amount of prostate specific antigen (PSA) in your blood (PSA is a protein produced by normal cells in the prostate and also by prostate cancer cells)
  • Digital Rectal Examination (DRE) – a type of physical examination where a doctor or nurse puts one of their fingers into your rectum (back passage) to feel for any abnormalities
  • Transrectal Ultrasound Guided Biopsy (TRUS) – an ultrasound probe (a machine that uses sound waves to build a picture of the inside of your body) is inserted into your rectum
  • CT scan – uses X-rays and a computer to create detailed images of the inside of the body
  • Intravenous Urogram – a test that uses X-rays and a special dye to help assess the kidneys, ureters, bladder and urethra
  • Image guided biopsy – combines an imaging procedure such as X-ray, computerized tomography (CT) scan, magnetic resonance imaging (MRI) scan or ultrasound — with a needle biopsy (special needle to extract cells)
  • X-ray – a test that produces images of the structures inside your body
  • MRI scan – a type of scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body
  • PET scan  – a scan used to produce detailed three-dimensional images of the inside of the body

Staging and grading

Your cancer specialist needs certain information about the cancer to decide on the most appropriate treatment for you.  This includes the stage and grade of the cancer.  The stage of a cancer describes its size, position and whether it has spread to beyond the area of the body where it started.

For more information on staging and grading of each urological cancer, please visit the Macmillan Cancer Support website. (http://www.macmillan.org.uk/Home.aspx)

Results

Your results will be discussed at the urological cancer multi-disciplinary meeting.  The team will review all aspects of your care and recommend an appropriate treatment plan.  A member of the team will discuss this with you.