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Should I see a bladder cancer specialist ?

Men and women discussing bladder cancer

This page tells you about seeing a bladder cancer specialist. You can find information about

 

A quick guide to what's on this page

Guidelines for seeing a bladder cancer specialist

The symptoms of bladder cancer can be very similar to symptoms of other less serious conditions. So it can be very difficult for GPs to decide who may have a suspected cancer and who has something much less serious. But there are particular symptoms that mean your GP should refer you to a specialist straight away. The National Institute for Health and Care Excellence (NICE) says that the following symptoms need referral to a specialist within 2 weeks

  • Blood in your urine with no symptoms of urine infection
  • Blood in your urine with other symptoms when urine infection is ruled out
  • Urine infection that won’t go away or keeps coming back, with blood in the urine, in anyone over 40
  • Very small amounts of blood in the urine for no apparent reason, in anyone over 50
  • A lump in your abdomen that your GP thinks could be related to your urinary system

If you have symptoms and you do not think your GP is taking them seriously enough, you could print out this page and take it to your appointment. You may be able to decide together whether you need to see a specialist, and how soon.

 

CR PDF Icon You can view and print the quick guides for all the pages in the About bladder cancer section.

 

 

Who should see a specialist

The symptoms of bladder cancer can be very similar to symptoms of other less serious conditions. So it can be very difficult for GPs to decide who may have a suspected cancer and who may have something minor that will go away on its own. With many symptoms, it is perfectly right that your GP should ask you to wait to see if they get better or respond to treatment such as antibiotics. If GPs referred everyone who came to see them to a specialist immediately, the system would get jammed and people needing urgent appointments wouldn't be able to get them. But there are particular symptoms that mean your GP should refer you to a specialist straight away.

 

The NICE guidelines

The National Institute for Health and Care Excellence (NICE) has produced guidelines for GPs to help them decide which patients need to be seen urgently by a specialist. While reading these guidelines, it is important to remember that

  • About 4 out of 5 people (80%) diagnosed with bladder cancer have seen blood in their urine
  • Most of the remaining people also have blood in their urine in amounts too small to see, but which can be picked up in a simple urine test
  • You are more likely to have bladder cancer if you have blood in your urine and are male, over 50, and a smoker
  • If you are under 40 and have blood in your urine it is unlikely that you have bladder cancer but you may have some type of kidney disease that needs investigation by a kidney specialist (nephrologist)
 

Guidelines for urgent referral

According to NICE guidelines, you should get an appointment within 2 weeks of an urgent referral. The symptoms that NICE say need urgent referral are

  • Blood in your urine, with no symptoms of urine infection (pain, frequency and urgency of passing urine)
  • Blood in the urine with other symptoms, after urine infection has been ruled out by your GP
  • Urine infection, with blood in the urine, that won't go away or keeps coming back in anyone over 40
  • Very small amounts of blood in the urine for no apparent reason in anyone over 50
  • A lump in your abdomen (either on a scan or felt by your doctor) that your GP thinks could be related to your urinary tract

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.

The guidelines suggest that you have further urine tests and blood tests if your urine tests positive for small amounts of blood. This is called microscopic haematuria because you can't see the blood with the naked eye. If you are under 50 and the results from these tests show your kidneys are not working properly, your doctor will send you to a kidney specialist. If the results are normal, you are likely to have a non urgent referral to a urologist.

 

If you are still worried

If you are worried that your GP is not taking your symptoms as seriously as you think they should, you could print this page and take it along to an appointment. Ask your GP to talk it through with you and then you may be able to decide together whether you need to see a specialist and if so, how soon.

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Updated: 21 October 2013