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Referral to a specialist

Find out when and why your GP may refer you to a bladder cancer specialist, and what to expect when you see one.

Seeing your GP

It can be hard for GPs to decide who may have cancer and who might have a more minor condition. For some symptoms, your doctor may ask you to wait to see if the symptoms get better or respond to treatment, such as antibiotics.

There are guidelines for GPs to help them decide who needs a referral.

UK referral guidelines

The National Institute for Health and Care Excellence (NICE) and Healthcare Improvement Scotland (HIS) produce guidelines for GPs in the UK. The guidelines help them decide who needs an urgent referral.

Urgent referral

Your GP should arrange for you to see a specialist within 2 weeks if you have symptoms that could be due to bladder cancer. This is called an urgent referral.

You should have an urgent referral if you are aged:

  • 45 or over with blood in the urine with or without a urine infection
  • 45 or over with blood in the urine with a urine infection that keeps coming back after treatment
  • 60 or over and have unexplained blood in the urine either with pain on passing urine or a raised white blood cell count

Your GP should consider a non-urgent referral to a specialist if you are aged 60 or over with a urine infection that won't go away or keeps coming back.

A urine infection will make your urine test positive to small amounts of protein and blood on a dip stick test. Women are more likely to get urine infections than men because the tube to the bladder (the urethra) is much shorter in women. So it is easier for germs to get into the bladder. So doctors are likely to want to rule out urine infection for women before making an urgent referral, but not necessarily for men.

Where you might see a specialist

Some hospitals have specialised clinics for people who have blood in their urine (haematuria).

Other hospitals have urology departments, which diagnose and treat people with any urinary system problems.

What happens at your appointment

Your specialist asks you about your medical history and symptoms. Then they examine you by feeling the area around your tummy (abdomen) and bladder.

You may be asked to have another internal examination. You may also need to give another urine sample.

Your specialist then arranges for you to have one or more tests to find out whether you have a bladder cancer.

Tests to diagnose bladder cancer

The first test most people have is a cystoscopy under a local anaesthetic.

In some hospitals or clinics you may have an intravenous urogram, an ultrasound scan or a CT scan first.

If you are still worried

Sometimes you might feel that your GP is not concerned enough about your symptoms. If you think they should be more concerned, print this page and the symptoms page. Ask your GP to talk it through with you. Together you can decide if you should see a specialist.

Information and help

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