No. He really cannot even be sure it is cancer from a visual assessment. However, urologists who treat bladder cancer have a lot of experience so he probably can make a pretty good guess that is it or is not cancer. The staging (grade and stage) cannot be determined except by a pathologist. Your tumor samples will be sent to a pathology lab for examination. Only after the results are back....and this can take up to a week or so....will you and your doctor know the exact diagnosis.
In fact it sometimes takes two TURBs to determine the exact situation. In my case the first result reported low grade papillary tumors with areas of "unspecified irritation." My urologist felt that it was necessary to examine these areas more closely so we did a second TURB with special attention to those areas of the bladder and the result was CIS which is high grade. While it took a couple of months to come up with the complete diagnosis I am so glad that my urologist was so thorough. I am now TEN YEARS out and still clear!!
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society