Urinary Tract Cancer Diagnosis
Symptoms of urinary tract cancers may include blood in the urine and increased frequency of urination. Most often, by the time clinical symptoms become apparent the cancer is more advanced.
Abnormalities in the bladder and kidneys may be detected through physical exam, with imaging tests of bladder or kidney function, by urine or blood tests or by examination of the bladder wall with a cystoscope. Kidneys cannot be easily palpated, but sometimes a renal mass is detected as an incidental finding on a CT scan performed for another ailment.
The stage of renal cancers depends on disease extent, size of tumor, nodal status, and the presence or absence of metastatic disease. The stage of urinary tract cancers also depends on those same factors, but in addition, the depth of the tumor invasion into the wall of the bladder or ureter is taken into consideration.
It is difficult to image primary tumors in the bladder or kidneys with PET/CT imaging, because substantial excretion of the radiopharmaceutical 2-Deoxy-2-[ 18F ]fluoro-D-Glucose (FDG) through the kidneys and into the bladder sometimes obscures the primary tumor and small nodal metastases located immediately adjacent to the bladder. PET/CT does, however, assist physicians in determining the stage of the cancer immediately after diagnosis by imaging local or systemic metastases of bladder of renal cancer.
Early determination of how far the cancer has spread helps the physician select the most appropriate treatment.
Source: Atlas of Clinical Positron Emission Tomography by Sallie F. Barrington, Michael N. Maisey and Richard R. Wahl. Oxford University Press, Inc. New York, NY. 2006.