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Test To Determine Bladder Cancer

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Tests Of Liver And Gallbladder Function

An Accurate & Non-Invasive Urine Test for Bladder Cancer | Cxbladder

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.

What Tests Screen For Bladder Cancer

  • Urine test: A urine cytology is an examination of urine under a microscope to test for abnormal cells. Your doctor can collect urine during a cystoscopy or you can provide a urine sample.
  • Blood tests: A comprehensive metabolic panel to test kidney and liver function tests.
  • Cystoscopy: A thin, flexible tube with a camera lens, called a cystoscope, is inserted in the urethra to examine it and the bladder for signs of disease. Your doctor also may take a tissue sample . A cystoscopy is an outpatient procedure that only takes about 5 to 10 minutes.
  • CT urogram: Computerized tomography of the bladder, ureters and kidneys is called a CT urogram. It can help identify where the cancer is and how big. The scan takes x-rays to create a 3-dimensional image. A CT urogram is usually an outpatient that takes 60 to 90 minutes.
  • Magnetic resonance imaging : An image test to look for signs of cancer or its spread to nearby tissues. MRIs do not use x-rays. The outpatient procedure takes about an hour and the patient lays on a table that slides into a tube.
  • Ultrasound: Using sound waves, ultrasounds look at the size of a tumor and if its spread to other organs. An ultrasound is an outpatient procedure that take less than 30 minutes.
  • PET scan: This scan uses radioactive tracers to show how tissue and organs are working.
  • Bone scan: A bone scan is used to look at the bones to diagnose any irregularities or problems.

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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Examples Of Fish Tests For Cancer

Although the FISH test is often used to analyze genetic abnormalities in breast cancer, it also can provide important information about many other types of cancer.

In the diagnosis of bladder cancer, for example, FISH testing of urinary cells may be more reliable than a standard test that looks for abnormal cells. In addition, FISH may detect bladder cancer recurrences three to six months earlier.

FISH also can identify chromosomal abnormalities in leukemias, including chronic lymphocytic leukemia cells, some of which are associated with aggressive forms of the disease. Patients with more aggressive forms of CLL may need urgent treatment, while those with less aggressive forms may only require observation.

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How Much Does A Bladder Ultrasound Cost

Bladder Cancer Monitoring

If you have medical insurance, your copayment for a bladder ultrasound can vary or may even be free. Without insurance, the average cost of an ultrasound in the United States is between about $250 and $400.

If you have Medicare, an ultrasound may be covered under your Part A coverage if you have the procedure during an inpatient hospital stay.

At an outpatient facility, an ultrasound is covered by Medicare Part B. Your share of the cost can be between about $17 and $30 depending on where the test is done.

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Causes Of Bladder Cancer

There are certain things that can affect the chances of developing bladder cancer. These are called risk factors.

The main risk factor is age. Bladder cancer is more common in people over the age of 60. It is rare in people under the age of 40. Another risk factor is smoking. Smoking may cause about 4 in 10 bladder cancers.

What Causes Bladder Cancer

Healthcare providers and researchers dont know exactly why certain bladder cells mutate and become cancerous cells. Theyve identified many different risk factors that may increase your chance of developing bladder cancer, including:

  • Cigarette smoke: Smoking cigarettes more than doubles your risk of developing bladder cancer. Smoking pipes and cigars and being exposed to second-hand smoke may also increase your risk.
  • Radiation exposure: Radiation therapy to treat cancer may increase your risk of developing bladder cancer.
  • Chemotherapy: Certain chemotherapy drugs may increase your risk.
  • Exposure to certain chemicals: Studies show that people who work with certain chemicals used in dyes, rubber, leather, paint, some textiles and hairdressing supplies may have an increased risk.
  • Frequent bladder infections: People who have frequent bladder infections, bladder stones or other urinary tract infections may be at an increased risk of squamous cell carcinoma.
  • Chronic catheter use: People who have a chronic need for a catheter in their bladder may be at risk for squamous cell carcinoma.

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Blood Test For Bladder Cancer

Get information on having blood tests. A blood test can help measure how well your kidneys are working.

Blood tests can:

  • check your general health, including how well your liver and kidneys are working
  • check numbers of blood cells
  • help diagnose cancer and other conditions

Your blood sample gets sent to the laboratory. Specialist technicians and doctors look at your sample under a microscope.

They can see the different types of cells and can count the different blood cells. They can also test for different kinds of chemicals and proteins in the blood.

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Bladder Tumor Antigen Stat And Trak

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The BTA STAT & TRAK tests use monoclonal antibodies to detect complement factor H-related protein and complement factor H in voided urine specimens. These factors are found in bladder cancer cell lines and inhibit the complement cascade to prevent cell lysis.BTA STAT is a point of care qualitative assay with an average sensitivity and specificity of 68.7% and 73.7% , respectively.BTA TRAK is a quantitative enzyme-linked immunosorbent assay with similar sensitivity and specificity of 62% and 73.6% , respectively. Studies have shown wide ranges of sensitivity and specificity with BTA testing. Additionally, the specificity of both of these tests can be significantly decreased, as false positives have been noted to occur in the setting of hematuria, urolithiasis, inflammation, recent instrumentation, other genitourinary malignancies, and intravesical BCG therapy.

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Diagnosis Of Bladder Cancer

Diagnosis is the process of finding out the cause of a health problem. Diagnosing bladder cancer usually begins with a visit to your family doctor. Your doctor will ask you about any symptoms you have and may do a physical exam. Based on this information, your doctor may refer you to a specialist or order tests to check for bladder cancer or other health problems.

The process of diagnosis may seem long and frustrating. Its normal to worry, but try to remember that other health conditions can cause similar symptoms as bladder cancer. Its important for the healthcare team to rule out other reasons for a health problem before making a diagnosis of bladder cancer.

The following tests are usually used to rule out or diagnose bladder cancer. Many of the same tests used to diagnose cancer are used to find out how far the cancer has spread . Your doctor may also order other tests to check your general health and to help plan your treatment.

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How Is Urine Collected For Cancer Cytology Tests

  • Urine is usually collected at your doctors office, clinic or a lab, but if it is 24-hour urine collection, you will be shown the procedure you will need for home collection.
  • In general, it is advisable to collect first-morning urine.
  • You may be provided with sterile, clean catch kit by your doctor containing a cleansing solution, sterile wipes, and collection container.
  • You wash your hands first, open the kit, clean your genital area and then begin urinating.
  • After the urine has flowed about half way, you collect midstream into the container, as you continue with the urine flow in the toilet until completion.
  • Careful tighten the lid on the urine container and return urine sample to your doctor.
  • Your urine sample will be sent to a lab within an hour for examination.

A urine sample can also be obtained during cystoscopy procedure .

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Comprehensive Imaging And Other Diagnostic Tests

At the U-M Rogel Cancer Center, a urologist will discuss your symptoms with you and perform a physical examination. Other tests that may be performed include:

  • Cytology: A urine test to detect cancer cells in the urine, similar to a Pap smear that detects cervical cancer in women. This test takes two or three days for a result, however, and in many cases is inconclusive.
  • Imaging: Most patients will require an imaging test that looks at the lining of the bladder. These tests may include a computed tomography scan, magnetic resonance imaging , or ultrasound. CT is the preferred test.
  • Cystoscopy: This test is performed by placing a tiny flexible lighted telescope into the urethra in the clinic and inspecting the urethra and bladder. If a tumor is seen or a suspicious area is identified, your doctor will then schedule a second flexible cystoscopy to be performed in the operating room under anesthetic. This allows for tumor removal, diagnosis and in some cases further therapeutic treatment. This procedure can also be performed in the clinic setting as part of a surveillance plan for already-diagnosed patients.

Urine Tumor Marker Test

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Urine marker tests look for substances in your urine that might indicate bladder cancer. There are several types. The lists these urine tumor marker tests for bladder cancer:

  • UroVysion looks for chromosomal changes in your bladder cells that might indicate cancer.
  • Bladder tumor-associated antigen tests check for BTA , a substance that cancer cells produce.
  • ImmunoCyt tests for mucin and carcinoembryonic antigen, two substances found on cancer cells.
  • NMP22 BladderChek looks for NMP22, a protein found in people with bladder cancer.

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What Is The Best Test To Detect Bladder Cancer

Cystoscopy. Cystoscopy is the key diagnostic procedure for bladder cancer. It allows the doctor to see inside the body with a thin, lighted, flexible tube called a cystoscope. Flexible cystoscopy is performed in a doctors office and does not require anesthesia, which is medication that blocks the awareness of pain.

Tumour Markers Blood Test

Tumour markers are substances that might be raised if there is a cancer. Theyre usually proteins. They can be found in the blood, urine or body tissues.

Some tumour markers are only produced by one type of cancer. Others can be made by several types. Some markers are found in non cancerous conditions as well as cancer.

Doctors might use tumour markers to help diagnose a cancer. And if you have cancer they can also help to monitor how well your cancer treatment is working or check if the cancer has come back.

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Urine Cytology Tests To Detect Cancer Cells

In a urine cytology test, a sample of the patients urine is analyzed under a microscope.1,2 This test can reveal the presence of cancer cells or cells that are pre-cancerous, meaning that they are more likely to become cancer cells later. However, this test is not enough to provide a definite diagnosis on its ownit is possible for cancer cells to be present in the bladder even if no cancer cells are detected in the urine sample.

Tumor Marker Tests: Mixed Results

Bladder Cancer Tests, Diagnosis and Recurrence

Technically, tumor markers are chemicals produced by cancerous cells that end up floating around in a patients blood. Some tumor markers are also made by healthy cells in the presence of cancers. That sounds like a clear sign of malignancy, but its not. Lots of people without cancer have elevated levels of tumor markers and the use of these tests in cancer diagnosis is still controversial.

Doctors usually look for proteins that accompany cancer, but recently, physicians have also started analyzing abnormalities in DNA and gene expression as tumor markers, too, according to the National Cancer Institute.

Theres no tumor marker that all cancers produce as a rule, at least not one thats been identified yet. But researchers have found proteins that specific types of tumor seem to produce:

  • Alpha-fetoprotein, a blood protein produced by amniotic fluid during normal fetal development, may be elevated in the presence of liver cancer and germ cell tumors like ovarian cancer and testicular cancer.
  • CA 19-9 is an antigen, a protein that may be manufactured by cancer cells and causes an immune system response. CA 19-9 levels are usually studied to manage pancreatic cancer, but a patients levels may also be elevated because of colorectal or esophageal cancer.

Finding cancer markers in blood work isnt enough to diagnose cancer, or screen patients for developing malignancies.

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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.
  • 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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What Can Be Detected In A Urine Test

Urine testing can assist in diagnosing many different disorders including kidney disease, diabetes, liver disorders, urinary tract infections , and bladder cancer.

Urine samples are routinely examined for physical properties , chemical composition and microscopic appearance . To detect bacteria, urine culture may also be performed, as described later.

Abnormal findings in a urine test can be characteristic of certain disease processes. For instance, persistently elevated protein in urine is a common early sign of chronic kidney disease, high levels of glucose may indicate diabetes, the detection of bacteria is often associated with a UTI, and the presence of red blood cells or abnormal cells may indicate bladder cancer.

In recent years there has been increasing use of molecular diagnostic tests to detect specific proteins or nucleic acids in urine to diagnose diseases such as UTIs, prostatitis, or bladder cancer. Cxbladder, for example, measures the urine concentration of messenger RNA expressed by five biomarker genes to determine the presence or absence of bladder cancer.

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Intravenous Or Retrograde Pyelograms

For example, intravenous or retrograde pyelograms are types of x-rays that use a special dye to highlight the organs of the urinary tract. This can make it possible to detect cancer that has spread to the kidneys, ureters, or other parts of the urinary tract. If healthcare providers suspect that the bladder cancer may have spread to the patients lungs, then a chest x-ray may be used.

How Do I Take Care Of Myself

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About half of all people with bladder cancer have early-stage cancer thats relatively easy to treat. But bladder cancer often comes back . People whove had bladder cancer will need regular checkups after treatment. Being vigilant about follow-up care is one thing you can do to take care of yourself. Here are some other suggestions from the Bladder Cancer Advocacy Network include:

  • Follow a heart-healthy diet: Plan menus that include skinless poultry and fish, low-fat dairy products, nuts and legumes, and a variety of fruits and vegetables.
  • Focus on high-fiber foods: Bladder cancer treatment may cause digestive issues and a fiber-rich diet may help.
  • Get some exercise: Gentle exercise may help manage stress.
  • Connect with others: Bladder cancer often comes back. Its not easy to have a rare disease thats likely to return. Connecting with people who understand what youre going through may help.

Urinary diversion

Some people with bladder cancer need surgery that removes their bladder and their bodies natural reservoir for pee. There are three types of urinary diversion surgeries. All three types involve surgically converting part of your intestine to become a passage tube for pee or a reservoir for storing pee.

Urinary diversion may be a challenging lifestyle change. If youll need urinary diversion surgery, ask your healthcare provider to explain each surgery types advantages and disadvantages. That way, youll know what to expect and how to take care of yourself.

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