Referral to a specialist

Your GP should arrange for you to see a specialist if you have symptoms that could be due to bladder cancer. Depending on your symptoms and other factors, this might be an urgent referral.

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.

UK referral guidelines

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

Some of the UK nations have targets around how quickly you’ll be seen. In England an urgent referral means that you should see a specialist within 2 weeks.

This 2 week time limit does not exist in Scotland, Wales and Northern Ireland. But wherever you live, you are seen as quickly as possible.

Ask your GP when you are likely to get an appointment.

Urgent referral to a specialist

The referral guidelines vary slightly between the different UK nations. The following is a summary.

Your doctor should arrange for you to see a specialist if you have symptoms that could be due to bladder cancer. Depending on the symptoms and other factors, this might be an urgent referral.

You should have an urgent referral if you are:

  • 45 or over and you can see blood in your urine and you don't have a urine infection
  • 45 or over and you can see blood in your urine, and you have a urine infection which keeps coming back after treatment
  • 60 or over and a dip stick test shows unexplained blood in the urine, and you also either have pain on passing urine or a raised white blood cell count
  • any age, and your doctor can feel a lump when they examine you or if a scan of your tummy (abdomen) shows a lump

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. The urethra is also closer to the opening of the bowel (anus) so it is easier for germs to get into the bladder.

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 and 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

Most people have a cystoscopy first. You have this under a local anaesthetic, so you're awake during the test. The test looks inside your bladder through a thin flexible tube, which the doctor puts through the tube where your urine comes out (urethra). 

If you're still worried

If you’re worried that your GP isn’t taking your symptoms seriously you could print this page and take it to your appointment.

Ask your GP to talk it through with you. Then you may be able to decide together whether you should see a specialist and how soon.

For information and support, you can contact the Cancer Research UK nurses on freephone 0808 800 4040, from 9am to 5pm, Monday to Friday.

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