I moved your post here to "Newly Diagnosed..." where more people will be able to share your experience.
Many patients who do have bladder cancer never have blood in the urine. So while that can be a sign of cancer, it is not always present.
The urologist will probably do an exam in his office...a cystoscopy...where he will examine the inside of the bladder with a tiny camera. However, since a mass was seen on the CT he may skip this step and go directly to a TURB (transurethral biopsy of the bladder.) This is usually an outpatient procedure (although some patients do stay overnight) where the urologist examines the bladder lining while you are under general anesthesia, removes the tumor if possible, and takes samples to send to the pathologist for examination. The report from the pathologist will provide the definitive information ...if it IS indeed cancer, what type, and what grade and stage it is. Only then will the urologist and you be able to decide on an appropriate treatment regimen.
If the tumor is bladder cancer, and is LOW GRADE, it is possible that the recommendation will be for no treatment, but to continue to monitor you with cystoscopy exams every three months. One of the characteristics of bladder cancer is that it tends to return, so it is important to have these exams!
If the tumor is HIGH GRADE (likely to spread) or has already spread into the lining of the bladder or into the muscle, the treatment options are different and vary according to what the pathologist reports.
Unfortunately, you cannot know the answers to any of these questions until the pathology report is done. Just know that many bladder cancers are highly treatable...for myself, I am now 6 years post diagnosis and totally without any symptoms.
Please feel free to ask any questions you may have....many others here on this Forum have been where you are!
Wishing you the best of luck!
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society