A physical exam is an important part of the diagnosis of urinary system cancers because sometimes this kind of cancer produces a lump or mass, i.e., a tumor that can be felt by the doctor. Also, there are specialized instruments that the doctor can use to look inside your urethra, bladder, or ureters. For example, a ureteroscope is a thin tube with a small light and camera on the end that allows your doctor to examine the lining of the ureters and take a tissue sample for a biopsy if necessary. A cystoscope is a similar instrument that provides your doctor with a close-up view of the urethra and bladder and also allows for a tissue sample to be collected. Your doctor might also conduct a pelvic exam or a rectal exam when diagnosing urethral cancer. Although some of these tests may seem invasive, they are usually performed after local or general anesthesia is provided.