A CT or MRI scan can sometimes show if and how far the bladder cancer has spread, but you might also need other imaging tests such as a radioisotope bone scan, x-rays or a PET-CT scan.
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Radioisotope bone scan
You may have a radioisotope scan to see whether the cancer has spread to the bones. It may also be called a whole-body bone scan (WBBS) or simply a bone scan.
Before you have the scan, a tiny amount of radioactive dye is injected into a vein, usually in your arm. You will need to wait for a few hours while the dye moves through your bloodstream to your bones. The dye collects in areas of abnormal bone growth. Your body will be scanned with a machine that detects radioactivity. A larger amount of radioactivity will show up in any areas of bone affected by cancer cells.
The scan is painless. After the scan, you need to drink plenty of fluids to help remove the radioactive substance from your body through your urine. It usually passes out of the body in a few hours. You should avoid being around young children and pregnant women for the rest of the day. Your treatment team will discuss these precautions with you.
X-rays
You may need x-rays if a particular area looks abnormal in other tests or is causing symptoms. A chest x-ray can check the health of your lungs and look for signs the cancer has spread. Sometimes, people will have a CT scan instead of an x-ray.
PET-CT scan
A PET (positron emission tomography) scan combined with a CT scan is a specialised imaging test. It can sometimes be used to find bladder cancer that has spread to lymph nodes or other areas of the body that may not be picked up on a CT scan. Ask what the scan will cost, as Medicare does not currently cover the cost of a PET–CT scan for bladder cancer.
Clinic staff will tell you how to prepare for a PET–CT scan, particularly if you have diabetes. Before the scan, you will be injected with a glucose solution containing a small amount of radioactive material. Cancer cells show up brighter on the scan because they take up more glucose solution than normal cells do. You will be asked to sit quietly for 30–90 minutes as the glucose moves through your body, then you will be scanned. It will take several hours to prepare for and have the PET–CT scan.
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Prof Dickon Hayne, Professor of Urology, UWA Medical School, The University of Western Australia, Chair of the Bladder, Urothelial and Penile Cancer Subcommittee, ANZUP Cancer Trials Group, and Head of Urology, South Metropolitan Health Service, WA; A/Prof Tom Shakespeare, Director, Radiation Oncology, Coffs Harbour, Port Macquarie and Lismore Public Hospitals, NSW; Helen Anderson, Genitourinary Cancer Nurse Navigator (CNS), Gold Coast University Hospital, QLD; BEAT Bladder Cancer Australia; Mark Jenkin, Consumer; Dr Ganessan Kichenadasse, Lead, SA Cancer Clinical Network, Commission of Excellence and Innovation in Health, and Medical Oncologist, Flinders Centre for Innovation in Cancer, SA; A/Prof James Lynam, Medical Oncology Staff Specialist, Calvary Mater Newcastle, NSW; Jack McDonald, Consumer; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Tara Redemski, Senior Physiotherapist – Cancer and Blood Disorders, Gold Coast University Hospital, QLD; Prof Shomik Sengupta, Consultant Urologist, Eastern Health and Professor of Surgery, Eastern Health Clinical School, Monash University, VIC.
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