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:
- 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.
How Does Fish Work
How FISH Works. During a FISH test using a sample of the patients tissue, special colored dyes are attached to specific parts of certain chromosomes in order to visualize and count them under a fluorescent microscope and to detect cancer -promoting abnormalities. Abnormalities found in cancer cells include: Translocation.
Early Detection And Screening
Because bladder cancer causes urinary symptoms such as blood in the urine, it may be found early. However, because blood in urine is caused by a lot of conditions other than cancer, urinalysis isnt a useful screening test for the general population.
There isnt a test yet that is able to screen the general population for bladder cancer. Doctors may recommend specific tests to screen for bladder cancer based on known risk factors.
Expert cancer care
Prognosis In Squamous Cell Carcinoma
Tumor stage, lymph node involvement, and tumor grade have been shown to be of independent prognostic value in SCC. However, pathologic stage is the most important prognostic factor. In one relatively large series of 154 cases, the overall 5-year survival rate was 56% for pT1 and 68% for pT2 tumors. However, the 5-year survival rate for pT3 and pT4 tumors was only 19%.
Several studies have demonstrated grading to be a significant morphologic parameter in SCC. In one series, 5-year survival rates for grade 1, 2, and 3 SCC was 62%, 52%, and 35%, respectively. In the same study of patients undergoing cystectomy, the investigators suggested that a higher number of newly formed blood vessels predicts unfavorable disease outcome.
In SCC, the survival rate appears to be better with radical surgery than with radiation therapy and/or chemotherapy. In locally advanced tumors, however, neoadjuvant radiation improves the outcome. Sex and age have not been prognostically significant in SCC.
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Side Effects Of Treatment For Bladder Cancer
All cancer treatments can have side effects. Your treatment team will discuss these with you before you start treatment. Talk to your doctor or nurse about any side effects you are experiencing. Some side effects can be upsetting and difficult, but there is help if you need it.
or email to speak with a caring cancer nurse for support.
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Where Do These Numbers Come From
The American Cancer Society relies on information from the SEER* database, maintained by the National Cancer Institute , to provide survival statistics for different types of cancer.
The SEER database tracks 5-year relative survival rates for bladder cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages . Instead, it groups cancers into localized, regional, and distant stages:
- Localized: There is no sign that the cancer has spread outside of the bladder.
- Regional: The cancer has spread from the bladder to nearby structures or lymph nodes.
- Distant: The cancer has spread to distant parts of the body such as the lungs, liver or bones.
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Would Cancer Show Up In Urine Test
Asked by: Mr. Stefan Lueilwitz DVM
Urinalysis can help find some bladder cancers early, but it has not been shown to be useful as a routine screening test. Urine cytology: In this test, a microscope is used to look for cancer cells in urine. Urine cytology does find some cancers, but it’s not reliable enough to make a good screening test.
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Can A Positive Fish Test Show Bladder Cancer
Positive FISH results in the absence of other signs or symptoms of bladder cancer recurrence may be evidence of other urinary tract-related cancers , and further patient follow-up may be helpful. Negative FISH results in the presence of other signs and symptoms of bladder cancer recurrence may need to be regarded as suspicious false-negative results repeat testing may be indicated. Although the assay was designed to detect chromosome changes associated with most bladder cancers, there are some bladder cancers whose genetic changes are not targeted by this test.
Can Molecular Markers Be Used In Reflex Testing For Bladder Cancer
Reflex testing, such as in the follow-up of patients with bladder cancer with an atypical cytology finding, is a logical approach. However, experience with this procedure at present is very limited and does not permit a definite statement. In consequence, this strategy should be exploited in more detail within prospective controlled studies.
Question: can molecular markers be used in reflex testing for bladder cancer?
Statement: At present experience with reflex testing is very limited and therefore does not permit a definite statement. Reflex testing should be explored in more detail within prospective controlled studies.
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Medical History And Physical Exam
Your doctor will want to get your medical history to learn more about your symptoms. The doctor might also ask about possible risk factors and your family history.
A physical exam can provide information about possible signs of bladder cancer and other health problems. The doctor might do a digital rectal exam , during which a gloved, lubricated finger is put into your rectum. If you are a woman, the doctor might do a pelvic exam as well. During these exams, the doctor can sometimes feel a bladder tumor, determine its size, and feel if and how far it has spread.
If the doctor finds things that aren’t normal, you may to have lab tests done and you might be referred to a urologist for further tests and treatment.
Stages Of Bladder Cancer
Staging describes or classifies a cancer based on how much cancer there is in the body and where it is when first diagnosed. This is often called the extent of cancer. Information from tests is used to find out the size of the tumour, which parts of the organ have cancer, whether the cancer has spread from where it first started and where the cancer has spread. Your healthcare team uses the stage to plan treatment and estimate the outcome .
The most common staging system for bladder cancer is the TNM system. For bladder cancer there are 5 stages stage 0 followed by stages 1 to 4. Often the stages 1 to 4 are written as the Roman numerals I, II, III and IV. Generally, the higher the stage number, the more the cancer has spread. Talk to your doctor if you have questions about staging.
When describing the stage, doctors may use the words local, regional or distant. Local means that the cancer is only in the bladder and has not spread to other parts of the body. Regional means close to the bladder or around it. Distant means in a part of the body farther from the bladder.
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What To Expect During Cystoscopy
The procedure generally takes about 15 to 20 minutes.
- Youâll need to pee first. The test is done with an empty bladder.
- Youâll lie down. The position depends on the type of scope your doctor uses:
- Standard rigid cystoscope. Youâll lie on your back with your knees up and apart. Your feet will probably be in stirrups.
- Flexible cystoscope. No special position is needed. The doctor will help you find a comfortable position.
Cxbladder Is A Genomic Urine Test For Bladder Cancer That Improves Overall Detection Accuracy
Cxbladder is a non-invasive and easy-to-use genomic urine test that quickly and accurately detects or rules out bladder cancer. The test combines clinical risk factor markers with genetic information, measuring five biomarker genes to detect the presence or absence of bladder cancer.
When should you use Cxbladder?
- When you’ve seen blood in your urine
- If tests reveal you have blood in your urine
- When you have had bladder cancer and are being monitored for recurrence
Cxbladder provides greater certainty, resolving diagnostic ambiguity and improving overall detection accuracy. The use of Cxbladder can also reduce the need for further invasive procedures and testing.
Bladder cancer has a high risk of recurrence so patients who have been treated have unique monitoring needs to protect against the threat of the disease returning. Besides monitoring for signs and symptoms of bladder cancer, a cystoscopy to examine the inside of the bladder and urethra is recommended every 312 months for several years after completing bladder cancer treatment, depending on the risk of recurrence. For many patients, the frequency of cystoscopy required can be reduced with the use of Cxbladder, a non-invasive surveillance alternative.
Cxbladders proven accuracy makes it a reliable choice. With performance proven in over 10 peer-reviewed studies, Cxbladder is trusted by over 1,800 urologists in over 40,000 patients. The test is covered by Medicare and comes with the option of in-home sampling.
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Genetic Aberrations In Bladder Cancer
The study of genetic aberrations commonly associated with urothelial carcinoma provides a more objective assessment for diagnosing and detecting recurrent disease. Homozygous loss of band 9p21, the site for the tumor suppressor gene P16, is a known early genetic event in the development of papillary carcinoma and urothelial carcinoma in situ .
Increased chromosomal instability and aneuploidy have been implicated in tumor progression. A study by Sokolova et al of 9 genetic markers for detecting urothelial carcinoma showed that polysomy of chromosomes 3, 7, and 17 and deletion of 9p21 were the most sensitive and specific markers, detecting 95% of recurrent urothelial carcinomas. Halling et al established that a threshold of 5 or more cells with polysomy was 84% sensitive and 92% specific for detecting recurrent urothelial cancer. Tests for mutations in the FGFR3 oncogene may also hold promise for diagnosing and predicting recurrence.
For muscle-invasive bladder cancer , a consensus on molecular classification has emerged. The consensus recognizes six molecular subgroup classes of MIBC, as follows:
- Luminal papillary
Differentiation patterns, oncogenic mechanisms, tumor micro-environments and histological and clinical associations are distinct for each of the six classes. However, research still needs to be conducted on the best clinical use of this classification.
Urine Lab Tests To Rule Out Bladder Cancer
If the healthcare provider thinks that bladder cancer may be the cause of the symptoms, the patient may be asked to provide a urine sample for analysis in the laboratory. Several types of urine lab tests may be used to help make a diagnosis of bladder cancer, including:
- Urinalysis testing
- Urine tests for tumor markers
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Urine Tumor Marker Tests
Different urine tests look for specific substances made by bladder cancer cells. One or more of these tests may be used along with urine cytology to help see if you have bladder cancer. These include the tests called NMP22® , BTA Stat®, Immunocyt® , and UroVysion®, which are discussed in Can Bladder Cancer Be Found Early?
Some doctors find these urine tests useful in looking for bladder cancers, but they may not help in all cases. Most doctors feel that cystoscopy is still the best way to find bladder cancer.
Some of these tests are more helpful for finding bladder cancer that has come back in someone who has already had it, rather than first diagnosing it.
Changes In Bladder Habits Or Symptoms Of Irritation
Bladder cancer can sometimes cause changes in urination, such as:
- Having to urinate more often than usual
- Pain or burning during urination
- Feeling as if you need to go right away, even when your bladder isn’t full
- Having trouble urinating or having a weak urine stream
- Having to get up to urinate many times during the night
These symptoms are more likely to be caused by a urinary tract infection , bladder stones, an overactive bladder, or an enlarged prostate . Still, its important to have them checked by a doctor so that the cause can be found and treated, if needed.
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What Is Cystoscopy Cystoscopy Test For Bladder Cancer
Cystoscopy derives from the thin fiber-optic tube instrument cystoscope that is inserted in your body through bladder to diagnose the internal happenings of your body. A German Army Surgeon Dr. Phillip Bozzinni invented and developed the instrument in 1807. Since then, it has been a significantly remarkable contribution to the urology field of medicine and health. Cystoscope have lens placed at its inserting end that reproduces the inside image focused upon by enlarging it. Urologist is the specialist Doctor that conducts Cystoscopy test for Bladder Cancer.
Usually stones, blockages, enlarged glands, bleeding, and related bladder abnormalities causes Cystoscopy.
The Cystoscopy test is conducted to find the cause of urinary system problems, bladder cancer, urinary infections, inject a dye for x-rays and kidney problems, collect tissue samples and eliminate foreign objects from the body.
Why Do I Need A Cystoscopy
You may have this test if you’re passing blood when you wee. Or you’re having problems passing urine, such as:
- being unable to empty your bladder properly
- you’re unable to control when you need to wee
- going more frequently than usual
This is the most important test for diagnosing cancer of the bladder. As well as examining the bladder your doctor can take samples of the bladder lining to check for cancer cells.
Other reasons you might have a cystoscopy is to check:
- whether your cancer has come back
- for spread from another type of cancer
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Role Of Urine Markers
Several reviews have been performed to assess the myriad urine markers proposed for bladder cancer surveillance. They note that none of the markers has been proven sensitive and specific enough to replace cystoscopy. While commercially available urinary markers are promising, the clinical evidence is insufficient to warrant the substitution of the cystoscopic follow-up scheme with any of the currently available urine marker tests. If FISH and NMP-22 are considered to have some utility when used to complement or replace cytology, a dilemma arises when their results conflict with each other. Of particular interest is how to treat a patient with positive cytology and/or FISH findings when cystoscopy findings are negative.
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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