Once a tumor has been identified, a biopsy is necessary to obtain a tissue sample, which is required in order to make a bladder cancer diagnosis and to determine the cancer staging. This procedure is usually done during the cystoscopy. 

The tumor tissue sample is removed from the bladder wall with an electrocautery loop during a procedure called a transurethral resection of bladder tumor (TURBT). Fox Chase Cancer Center pathologists who specialize in reviewing bladder tissue can diagnose the type and stage of bladder cancer and determine if the cancer is invasive or non-invasive.

The pathologist who examines the tissue also describes the grade of the cancer:

• Low grade cancers look more similar to normal bladder  tissue and tend to remain on the surface of the bladder
• High grade cancers look more abnormal and are of greater risk for growing invasively, through the superficial lining layer

Both low grade and high grade bladder cancers commonly recur, or come back, after an initial treatment, but low grade cancers are less likely to spread beyond the bladder when they recur.

Fox Chase radiologists and pathologists who specialize in bladder cancer review all available diagnostic tests in order to make an informed diagnosis.