A New Step Forward For Early Detection of Bladder Cancer
By John Corso M.D.
Bladder cancer, while not the scary scourge of lung, breast or colon cancer, is still a medium-sized killer, showing up in about 50,000 new people a year and killing about 11,000 of them.
The most we currently do in this country to detect it is to check urine samples once a year for blood that may or may not be visible to the naked eye. The experts with The United States Preventive Services Task Force (USPSTF) don t even recommend that much, since there is not yet evidence that doing so saves lives.
Microscopic levels of blood in the urine are pretty common and usually don t mean cancer of the bladder (or kidney). Small amounts of blood can come from other things like bladder or prostate infection, kidney stones, toxic medications, heavy exercise, menstruation, sexual activity, and the list goes on.
On top of that, urine screening can easily miss cancers that aren t bleeding on the day of our physical. I once gave a clean bill of bladder-health to a patient and colleague based on a normal urine test. Six months later he was urinating blood. He had an aggressive bladder cancer that had gone unrecognized by the standard urine test.
For the past few years I ve tried to go a bit farther by offering cytology testing to my patients. This requires submitting that same urine sample to an expert, a pathologist, who can look for both bladder and kidney cancer cells in urine samples. We know we can discover both bladder and kidney cancer a bit earlier this way.
The catch is that while cancer cells in the urine clearly means there is a problem, the absence of cancer cells does not mean we re OK. A single annual cytology test can also miss about half of these tumors. There s been no downside to cytology screening (false-positive results are extremely rare) and the out-of-pocket cost was about 45 bucks.
Enter UroVysion
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