What Is Renal Ultrasound
Renal ultrasound is the least invasive way to evaluate the kidneys. It does not require radiation and avoids contrast. It may be used in lower risk patients and those with contrast allergies or poor renal function. Unfortunately, it can miss small kidney stones and tumors. Also, it will not detect tumors in the ureter unless they are causing a blockage leading to hydronephrosis.
How Are Samples Collected
Requirements for urine sampling vary depending on the test/s being performed. Often the timing of collection is random, as dictated by the logistics of a doctor consult or access to a laboratory service. However, depending on the purpose of the test, certain urine voids of the day may be preferred. Collection of urine from all voids over a defined time period or sample collection at specific times after eating may also be necessary.
Urine samples are usually obtained by spontaneous voiding, using the clean-catch, midstream urine collection method. This involves voiding the first portion of urine into the toilet, collecting the midstream portion into a clean container, then voiding the remaining portion into the toilet. This method greatly reduces the risk of contaminants entering the sample. Less commonly, an invasive method of urine collection, such as placement of a urinary catheter, may be required.
Learn about Cxbladder’s easy-to-use in-home sampling system
Blood Parameters Normal Values & How Does Cancer Show Up In A Routine Blood Work
|Reed-Sternberg cells||Hodgkins Lymphoma|
It is quite clear from the tables above that a routine blood work is able to diagnose blood cancers. It can also show how well your bone marrow and spleen may be working.
Relationship Between Colon Cancer and A Complete Blood Count
1.A retrospective study was conducted to evaluate the value of a complete blood count in predicting cancer of colon over a period of 5 years. The study revealed
Out of 127 Patients Who Had Cancer of Right Side of Colon, Showed
- 87% patients had a high red cell distribution width
- 69% patients had anemia
- 55% patients had a low MCV
Out of 98 Patients Who Had Cancer of Left Side of Colon, Showed
- 50% patients had elevated red cell distribution width
- 44% patients had anemia
- 22% patients had a low MCV
Red Cell Distribution Width Diameter of a normal red blood cell measures 6-8 micrometers. If cells are large, RDW will be high.
It was observed that red cell distribution width was 88% specific for cancer of right side of the colon. And therefore, this parameter could be used for screening purposes among high risk groups.
2.Another study was conducted over a wide period of 15 years to understand the proportion of iron deficiency anemia is patients having right sided cancer of colon.
So the question that remains, does cancer show up in routine blood work?
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Urine Tests For Tumor Markers
A relatively new type of diagnostic technology for bladder cancer are urine tests for substances called tumor markers.3 It is possible for these tests to detect substances in the urine that may be linked to the presence of bladder cancer cells, but like urine cytology test, they are not perfectly reliable. These new tests include:
- Tests that can detect bladder tumor-associated antigen
- A test that can detect the genetic changes that are common in bladder cancer cells
- A test that can detect substances often found on cancer cells, called mucin and carcinoembryonic antigen
- A test that can detect a protein that is often elevated in patients with bladder cancer
Benefits Of Urine Testing
Urine testing has several advantages, including:
- Typically non-invasive and painless
- Ease of sampling, coupled with being quick and convenient compared with other tests and procedures
- Results can be obtained quickly
- Costs are often lower than those associated with other types of diagnostic tests and procedures
- Provides relevant, reliable information regarding patient health status
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Tests Of Liver And Gallbladder Function
Lab tests might be done to find out how much bilirubin is in your blood. Bilirubin is the chemical that causes jaundice. Problems in the gallbladder, bile ducts, or liver can raise the blood level of bilirubin.
The doctor may also do tests for albumin, liver enzymes , and certain other substances in your blood. These may be calledliver function tests. They can help diagnose liver, bile duct, or gallbladder disease.
Why Did We Fail In The Past
Although noninvasive tests are labelled to diagnose bladder cancer, it remains unclear how they can effectively be integrated into clinical decision-making, particularly when making an initial diagnosis because the presenting signs and symptoms may be caused by a number of different diseases and conditions. This situation is different from that in prostate cancer screening where the diagnosis is usually being sought in asymptomatic individuals who may themselves request a screening test.
It seems obvious that new tests for the initial diagnosis of bladder cancer should be investigated in patients with symptoms and/or signs associated with this disease. This will pertain largely to patients who have gross hematuria, those who may have irritative voiding symptoms without urinary tract infection, and those found on routine urinalysis to have microscopic hematuria. However, an investigation of the literature shows that this approach is often neglected. In contrast, the vast majority of studies are case-control trials comparing artificially composed study cohorts, in which the prevalence of the disease frequently exceeds 50%. High disease prevalence is usually not seen in urological practice and such an evaluation is likely to result in an optimistic assessment of the positive predictive value .
Urine testing has several advantages, including:
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Tests To Find Bladder Cancer
To find bladder cancer, doctors may run tests to see whether there are certain substancessuch as bloodin the urine. Tests may include:
- Urine cytology
- Urine culture
For patients who have symptoms or have had bladder cancer in the past, newer tests that look for tumor markers in urine may include:
- BTA tests
- NMP22 BladderChek®
Researchers dont know yet whether these tests are reliable enough to be used for screening, but they may help find some bladder cancers.
Most doctors recommend a cystoscopy to find bladder cancer, and its often performed without anesthesia. During this procedure, the doctor inserts a long, thin tube with a camera into the urethra to see the inside of the bladder for growths and collect a tissue sample . The tissue is studied in a lab to search for cancer and obtain more information. During a cystoscopy, doctors may also perform a fluorescence cystoscopy, or blue light cystoscopy, inserting a light-activated drug into the bladder and seeing whether any cancer cells glow when they shine a blue light through the tube.
Doctors may also order imaging tests to see whether the cancer has spread. The most common imaging tests include:
Magnetic resonance imaging uses magnets and radio waves to take pictures of the inside of the body. Before the test, a contrast medium is administered orally or by injection to help make the scan clearer.
Ultrasound uses sound waves to take pictures of the inside of the body.
Possible Risks Of Having A Blood Test
Blood sampling is a safe test. There is a possibility of:
- bleeding and bruising – pressing hard when the needle is removed can help to stop it
- pain – this is normally mild and can last for a few minutes
- swelling – ask your nurse, doctor or phlebotomist to avoid an arm that is swollen or has a risk of swelling
- feeling faint or fainting – tell the person doing your blood test if you’re feeling lightheaded or dizzy at any time
- infection – this is very rare
Oxford handbook of clinical medicine M Longmore and other
Bladder cancer: overview and disease management. Part 1: non-muscle-invasive bladder cancerB AndersonBritish Journal of Nursing, 2018. Volume 27, Issue 9, pages 27 37
Bladder cancer: ESMO Practice Guidelines for diagnosis, treatment and follow-upJ Bellmunt and othersAnnals of Oncology, 2014. Volume 25, Issue 3, Pages 40-48
BMJ Best Practice. Bladder CancerD LammBMJ Publishing Group,
The Royal Marsden Manual of Clinical Nursing Procedures L Dougherty and S ListerWiley Blackwell, 2015
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Urine Cytology Tests After A Cystoscopy
Urine cytology tests can also be used after a procedure called cystoscopy, in which a sterile liquid is injected into the bladder to allow the bladder to expand so it can be adequately examined. When the liquid is removed from the bladder it may be analyzed with cytology testing to check for the presence of cancer or pre-cancer cells.
What Tests Are Most Often Used To Diagnose Kidney Cancer
Blood tests are not enough to diagnose kidney cancer. If your doctor suspects kidney cancer, youll likely have a range of other tests to confirm your diagnosis. This often includes:
- CT scan. A CT scan uses multiple X-ray images to create detailed images of your kidneys so doctors can look for tumors and other issues.
- MRI. An MRI uses magnetic imaging to create images of your kidney to check the size, shape, and location of any tumors.
- Ultrasound. An ultrasound uses sound waves to create images of your kidneys. It can help locate tumors and whether they are benign or cancerous.
- Bone scan. A bone scan can be done to see the inside of your bones. Your doctor might do this test if they suspect cancer has spread to your bones.
- Biopsy. During a biopsy, a small piece of your kidney is removed with a needle so it can be tested in a lab. Biopsy results can confirm cancer and help diagnose the stage of the tumor.
- Renal angiography.This test helps your doctor see the blood supply to your kidneys in detail. Blood supply to a tumor, if present, is also able to be seen here.
- Intravenous pyelogram. This test requires dye to be injected into a vein so the kidneys are more visible via X-ray. This is another way an obstruction or tumor can be detected.
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Can Molecular Markers Support Follow
There is clear evidence that modern molecular markers outperform urine cytology concerning sensitivity in the diagnosis of patients with noninvasive low-grade tumors. In addition, due to the low risk of tumor progression, marker-guided surveillance could significantly reduce the number of control cystoscopies without placing patients at significant risk. However, to date only one prospective trial using a marker-guided surveillance protocol has been performed . Information from this study, however, is still preliminary and does not yet permit recommendation of this procedure for clinical routine use.
Question: can molecular markers support follow-up of patients with superficial low-risk bladder cancer?
Statement: Marker-guided follow-up of patients with non-muscle-invasive low-risk tumors appears feasible. However, studies proving the efficacy of this concept and demonstrating an added value for patients or the health system are lacking.
Recommendation: Marker-guided follow-up of patients with superficial low-grade bladder cancer appears attractive however, based upon current levels of evidence this procedure cannot be recommended at present.
LoE: 1b grade: B agreement: 92%.
Microscopy Examination Of Urine
- This test is also known as urine cytology test. It involves viewing urine sample under the microscope for the presence of significant amount of different types of cells and in the case of pre-cancer or cancer cells, the test also looks at their characteristics.
- The appearances of red blood cells and white blood cells in the urine are due to kidney or bladder injury or inflammation. They can also be due to urinary tract infection , bladder cancer, lupus or inflammation of the vagina or the foreskin of the penis .
- Special microscopes are use to tell the presence of precancer and cancer cells and their abnormal activities.
- When urine is being examine under the microscope, tiny tube-shaped particles may be seen. These are called urinary casts. They may consist of proteins, fats, red blood cells,white blood cells or kidney cells. A number of casts provide information about healthy or abnormal kidney function.
- If crystals are found in the urine, they may result from the formation of kidney stones, certain types of medications in use or metabolic disorder.
- If bacteria or yeasts are found, it could be due to UTI.
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How Bladder Cancer Is Diagnosed
There are many tests used for diagnosing bladder cancer. Not all tests described here will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:
The type of cancer suspected
Your signs and symptoms
Your age and general health
The results of earlier medical tests
The earlier bladder cancer is found, the better the chance for successful treatment and cure. However, there is not yet a test accurate enough to screen the general population for bladder cancer, so most people are diagnosed with bladder cancer once they have symptoms. As a result, some people have more advanced disease when the cancer is found. Still, most people are usually diagnosed with noninvasive bladder cancer .
The following tests may be used to diagnose and learn more about bladder cancer:
The following imaging tests may be used to find out if the bladder cancer has spread and to help with staging. Imaging tests show pictures of the inside of the body.
After diagnostic tests are done, your doctor will review the results with you. If the diagnosis is cancer, these results also help the doctor describe the cancer. This is called staging and grading.
The next section in this guide is Stages and Grades. It explains the systems doctors use to describe the extent of the disease and the way cancer cells look under a microscope. Use the menu to choose a different section to read in this guide.
Tests For Bladder Cancer
Bladder cancer is often found because of signs or symptoms a person is having. Or it might be found because of lab tests a person gets for another reason. If bladder cancer is suspected, exams and tests will be needed to confirm the diagnosis. If cancer is found, more tests will be done to help find out the extent of the cancer.
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How Do I Prepare For Urine Collection For Cytology Tests
- Certain foods such as sugar beets, blackberries, or rhubarb can color urine and made it appear like it contains blood so avoid eating any of them prior to the test.
- Tell your doctor if you are on medication such as vitamin B, Pyridium and Dilantin an . These drugs will also color the urine.
- If your monthly cycle falls within the date you are ask to give a urine sample, let your doctor know, so you can be re-schedule to give your urine sample at a later date.
- Drink enough water prior to giving a urine sample so you can have enough urine volume give midstream urine.
Understanding Invasiveness And Grade
Two important pieces of information to know about this specific cancer are its invasiveness and grade.
Invasiveness describes how deep the cancer is in the bladder wall, which is crucial to determining treatment. If the cancer is in the inner cell layers, its noninvasive or superficial. If its grown into deeper bladder layers or spread to other organs or lymph nodes, its invasive.
Grade describes how bladder cancer cells look under a microscope. Low-grade cancers, also called well-differentiated cancers, resemble regular bladder cells. High-grade, poorly differentiated or undifferentiated cancers dont look as much like normal bladder cells, and theyre more likely to become invasive or spread to other body parts.
Invasive and high-grade cancers may be harder to treat than noninvasive and low-grade ones. They may also require a different kind of treatment.
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What Do Your Lab Test Results Mean
Ever logged into MyChart to check on some lab test results, then just stared blankly at the screen once you saw them? Youre not alone.
Unless you work in the medical field, figuring out what all of those values mean and how to interpret them can sometimes be a challenge.
We sought insight from Adriana Maria Knopfelmacher-Couchonal, M.D., a specialist in Laboratory Medicine. Heres what she had to say.
How are lab tests used in cancer care?
What types of lab tests are used in cancer diagnosis and treatment?
There are too many different kinds to list. But the complete blood count is probably the most common lab test performed. It measures three main things:
What are the reference ranges for?
Reference ranges are designed to give people an idea of what normal values are for those categories. Theyre created by averaging the results of large numbers of healthy individuals.
What other lab tests are used in cancer care?
Doctors look at six different values to gauge liver function: