does abnormal urine fish test always indicate bladder 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.

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How do you detect bladder cancer?

Urine cytology tests to detect cancer cells. In a urine cytology test, a sample of the patient’s 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 own—it is possible for cancer cells to …

How to diagnose bladder cancer?

 · Recent analyses indicate that urine cytology detects only around 50% of high-grade tumors and 10% of low-grade tumors, with an overall sensitivity for bladder cancer detection of approximately 40%. 1 This means that overall, approximately 60% of all bladder cancers will be missed by urine cytology. While a positive urine cytology result does reliably indicate the …

What causes cancer in the bladder?

 · FISH is 42-83% sensitive for detecting pTa and pT1 lesions and 92-100% sensitive for pT2-4 invasive lesions in patients with known bladder cancer, while urine cytology yields sensitivities of 24 …

How can urine tests detect bladder cancer?

For this test, a sample of urine is looked at with a microscope to see if there are any cancer or pre-cancer cells in it. Cytology is also done on any bladder washings taken during a cystoscopy (see below). Cytology can help find some cancers, but it isn’t perfect. Not finding cancer on this test doesn’t always mean you are cancer free. Urine culture

Does a positive FISH test mean cancer?

What the Results Mean. FISH testing usually returns one of two results: positive or negative. Positive means your breast cancer cells make too much HER2 and your doctor should treat you with drugs that target that protein. Negative means the protein isn’t involved in the growth of your tumor.

Does bladder cancer show up in urinalysis?

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.

How accurate is urine test for bladder cancer?

Recent analyses indicate that urine cytology detects only around 50% of high-grade tumors and 10% of low-grade tumors, with an overall sensitivity for bladder cancer detection of approximately 40%. This means that overall, approximately 60% of all bladder cancers will be missed by urine cytology.

Does abnormal cells in urine mean cancer?

Abnormal cells in the urine may be a sign of inflammation of the urinary tract or cancer of the kidney , ureters, bladder, or urethra.

How do you rule out bladder cancer?

A sample of your urine is analyzed under a microscope to check for cancer cells in a procedure called urine cytology. Imaging tests. Imaging tests, such as computerized tomography (CT) urogram or retrograde pyelogram, allow your doctor to examine the structures of your urinary tract.

What is usually the first symptom of bladder cancer?

In most cases, blood in the urine (called hematuria) is the first sign of bladder cancer. There may be enough blood to change the color of the urine to orange, pink, or, less often, dark red.

What is the best test for bladder cancer?

Urine tumor marker tests 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.

What are the warning signs of bladder cancer?

Bladder Cancer: Symptoms and SignsBlood or blood clots in the urine.Pain or burning sensation during urination.Frequent urination.Feeling the need to urinate many times throughout the night.Feeling the need to urinate, but not being able to pass urine.Lower back pain on 1 side of the body.

What is present in urine of patients with bladder cancer?

These assays detect human complement factor H-related protein (as well as complement factor H), which is present in the urine of patients with bladder cancer. It is believed that complement factor H production by tumor cells may prevent tumor cell lysis by immune cells.

Why do I have abnormal cells in my urine?

If bacteria or yeast are present in the culture, you probably have a bladder or urinary tract infection. Antibiotics can usually treat these conditions. Cells that appear abnormal in your urine may also indicate inflammation in the urinary tract or cancer of the bladder, kidney, ureter, or urethra.

What does abnormal urine cytology mean?

This test looks at a sample of your urine to see if it contains abnormal cells. The test is used to diagnose cancers of the urinary tract. These include cancers of the kidney, bladder, ureter, and urethra. A healthcare provider called a pathologist looks at the cells from your urine sample under a microscope.

Can bladder cancer be missed on ultrasound?

While bladder tumors may be visualized using ultrasound, a negative test does not exclude the presence of bladder cancer. An ultrasound may also not have sufficient sensitivity to detect small tumors and is unable to detect tumors in some parts of the urinary tract (for example, the ureters).

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, includi…

Transurethral Resection of Bladder Tumor (TURBT)

If an abnormal area (or areas) is seen during a cystoscopy, it will be biopsied to see if it is cancer. A biopsy is the removal of small samples of…

Biopsies to Look For Cancer Spread

If imaging tests suggest the cancer might have spread outside of the bladder, a biopsy might be needed to be sure.In some cases, biopsy samples of…

Why is a fish test used for breast 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.

What is a fish test?

Fluorescence in situ hybridization (FISH) is a test that “maps” the genetic material in human cells, including specific genes or portions of genes. Because a FISH test can detect genetic abnormalities associated with cancer, it’s useful for diagnosing some types of the disease.

Why is the fish test used?

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.

Why is a fish test important?

Because a FISH test can detect genetic abnormalities associated with cancer, it’s useful for diagnosing some types of the disease. When the type of cancer has previously been diagnosed, a FISH test also may provide additional information to help predict a patient’s outcome and whether he or she is likely to respond to chemotherapy drugs.

How long does it take for a fish test to be done?

Because other tests cannot be performed until cancer cells have been growing in lab dishes for about two weeks, the process usually takes about three weeks. FISH results are usually available within a few days. Examples of FISH Tests for Cancer.

Is fish testing expensive?

Other treatment options for HER2 include: Because FISH testing is expensive and not widely available, it’s not as commonly used as another breast cancer test: ImmunoHistoChemistry (IHC).

Can fish detect leukemia?

FISH also can identify chromosomal abnormalities in leukemias, including chronic lymphocytic leukemia (CLL) 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.

What is the best test for bladder cancer?

Several types of urine test have an important role in the overall process of diagnosing bladder cancer. Among these tests, urine cytology and urine tumor marker tests are used to detect the presence or absence of bladder cancer. Urine cytology has been used to assist bladder cancer diagnosis for over 75 years and has well-established strengths and limitations which are discussed in more detail below. Molecular tumor marker tests such as Cxbladder have been more recently developed, and provide high diagnostic accuracy in both detection and rule-out.

What does it mean when you have abnormal urine?

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.

How to collect urine samples?

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.

What is urine made of?

Urine is made up of several components including water and waste materials filtered from the blood by the kidneys, as well as small numbers of cells such as epithelial cells shed from the lining of the urinary tract and possibly red and white blood cells . The type and quantity of the different components and cells contained in urine can provide important information regarding an individual’s health, which can help in the diagnosis of diseases such as bladder cancer.

What is the test used to detect RNA in urine?

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

What are the physical properties of urine?

Urine samples are routinely examined for physical properties (e.g., color, clarity, odor, density), chemical composition (e.g., pH, protein, glucose; commonly determined by a simple dipstick test) and microscopic appearance (e.g., the presence of cells, crystals, or bacteria). To detect bacteria, urine culture may also be performed, as described later.

How to contact CXbladder?

Contact us by phone or email, or fill out an online form and a Cxbladder representative will get back to you.

How sensitive is fish to bladder cancer?

Initial comparisons of urine cytology with FISH for detecting bladder cancer recurrence showed that FISH yielded a greater sensitivity. [ 13] FISH is 42-83% sensitive for detecting pTa and pT1 lesions and 92-100% sensitive for pT2-4 invasive lesions in patients with known bladder cancer, while urine cytology yields sensitivities of 24-50% for pTa and pT1 lesions and 78-85% for pT2-4 invasive lesions. [ 14]

Is fish cytology sensitive to bladder cancer?

Initial comparisons of urine cytology with FISH for detecting bladder cancer recurrence showed that FISH yielded a greater sensitivity. [ 13] FISH is 42-83% sensitive for detecting pTa and pT1 lesions and 92-100% sensitive for pT2-4 invasive lesions in patients with known bladder cancer, while urine cytology yields sensitivities of 24-50% for pTa and pT1 lesions and 78-85% for pT2-4 invasive lesions. [ 14]

What tests are used to check for bladder cancer?

These include the tests called NMP22 ® (or BladderChek ® ), BTA Stat ®, Immunocyt ® , and UroVysion ®, which are discussed in Can Bladder Cancer Be Found Early?

What is the best way to diagnose bladder cancer?

Cystoscopy. If bladder cancer is suspected, most doctors will recommend a cystoscopy. . A urologist uses a cystoscope, which is a long, thin, flexible tube with a light and a lens or a small video camera on the end. For details on how this procedure is done, see Cystoscopy.

What is the blue light in a cystoscopy?

Fluorescence cystoscopy (also known as blue light cystoscopy) may be done along with routine cystoscopy. For this exam, a light-activated drug is put into the bladder during cystoscopy. It’s taken up by cancer cells. When the doctor then shines a blue light through the cystoscope, any cells containing the drug will glow (fluoresce). This can help the doctor see abnormal areas that might have been missed by the white light normally used.

What is the biopsy for bladder cancer?

A biopsy is when tiny pieces (called samples) of the abnormal-looking tissue are taken out and tested for cancer cells. If bladder cancer is suspected, a biopsy is needed to be sure of the diagnosis.

What is a physical exam for bladder cancer?

A physical exam can provide information about possible signs of bladder cancer and other health problems. The doctor might do a digital rectal exam (DRE), 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.

How long does it take for a urine culture to show up?

It can take time for the bacteria to grow, so it may take a few days to get the results of this test.

How does ultrasound help with bladder cancer?

Ultrasound uses sound waves to create pictures of internal organs. It can be useful in determining the size of a bladder cancer and whether it has spread beyond the bladder to nearby organs or tissues. It can also be used to look at the kidneys. This is usually an easy test to have, and it uses no radiation.

What are the symptoms of bladder cancer?

Being unable to urinate. Lower back pain on one side. Loss of appetite and weight loss. Feeling tired or weak. Swelling in the feet. Bone pain. Again, many of these symptoms are more likely to be caused by something other than bladder cancer, but it’s important to have them checked.

How long does urine stay clear after bladder cancer?

Blood may be present one day and absent the next, with the urine remaining clear for weeks or even months. But if a person has bladder cancer, at some point the blood reappears.

Why is bladder cancer so early?

Bladder cancer can often be found early because it causes blood in the urine or other urinary symptoms that cause a person to see a health care provider.

Why does urine have blood in it?

More often it’s caused by other things like an infection, benign (not cancer) tumors, stones in the kidney or bladder, or other benign kidney diseases. Still, it’s important to have it checked by a doctor so the cause can be found.

Why do I have trouble peeing?

Having to get up to urinate many times during the night. These symptoms are more likely to be caused by a urinary tract infection (UTI), bladder stones, an overactive bladder, or an enlarged prostate (in men).

Can bladder cancer cause a change in urination?

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.

Why do oncologists use fish?

Medical center lab personnel and oncologists use FISH to help assess patients who may have cancer, and sometimes to monitor a patient who has already been diagnosed with cancer and treated. 2 . FISH can be done using various types of samples according to the location and the type of cancer suspected: Tumor cells obtained from peripheral blood, …

How long does it take for a fish test to be done?

An advantage of FISH is that it doesn’t have to be performed on cells that are actively dividing. Cytogenetic testing usually takes about three weeks, because the cancer cells must grow in lab dishes for about 2 weeks before they can be tested. In contrast, FISH results are usually available from the lab within a few days. 7 .

Does fish detect cancer?

The genetic changes detected by FISH sometimes offer additional information about how an individual’s cancer is likely to behave, based on what’s been observed in the past in people with the same kind of cancer and similar genetic changes.

Can cancer be genetic?

Many different types of cancer are associated with known genetic abnormalities. And by genetic, we are not just talking about heredity. Over a lifetime, cells can make mistakes when they divide and grow. Mutations in the DNA that are associated with cancer may accumulate in these cells.

Can fish detect CLL?

FISH can identify chromosomal abnormalities in leukemias, including in chronic lymphocytic leukemia (CLL). 5  For chronic lymphocytic leukemia/small lymphocytic lymphoma, FISH allows patients to find out their prognostic category: good, intermediate, or poor. In acute lymphoblastic leukemia (ALL), genetics of the leukemic cells can tell you about the risk level of cancer and help to guide therapeutic decisions.

How accurate is the fish test?

Here’s a set of studies sourced at WebMD that provides readable information and specific outcomes. In the initial clinical testing accuracy was 84%. Please see quote below from Medscape article on WebMD with credit to authors and publications. “Applicability of the FISH Test For Bladder Cancer Peggy Ward-Smith, PhD, RN, Brenda Miller, MSN, RN, Michael Caughron, MD Clinical Application of the FISH Test Gofrit and associates (2008) followed patients diagnosed with non-muscle invasive bladder cancer treated by transurethral resection for a median of 13.5 months. An abnormal FISH result preceded the diagnosis of tumor recurrence in 18 of 21 cases (86%), including all high-grade recurrences. These data suggest that FISH assay may be a particularly useful tool for predicting tumor recurrence. However, the implementation of FISH analysis or any other assay as a substitution for cystoscopy is not recommended at this time. Gofrit et al. (2008) suggest that cystoscopy may be spared and surveillance intervals widened in patients with a history of low-grade tumors and normal FISH test (s). The initial clinical testing using FISH as a diagnostic tool included 497 patients receiving care at 23 health care sites (Sarosdy et al., 2006). Participation in this study was limited to individuals who presented with hematuria and had no previous history of bladder cancer. After excluding very low-grade tumors, FISH was able to detect cancer in 25 of 30 (84%) cases; cytology was detected 15 (50%) cases. The capability of FISH to detect bladder cancer is somewhat less if the patient has a smoking history or presently smokes. In patients with a greater than 40-pack-per-year history of smoking, FISH was able to detect cancer 65% of the time. For those with less than 20 or 20-to-40-pack-per-year smoking history, or with no smoking history, this ability decreased to 13.6% to 24.2%. Overall, the results of this study indicate that FISH demonstrates a 68.6% clinical sensitivity and a 77.7% clinical specificity in detecting bladder cancer. Based on these results, the FDA approved Abbott’s UroVysionTM DNA probe (FISH) as a diagnostic tool for bladder cancer in 2005. Presently, FISH is used as an aid in the initial diagnosis of bladder cancer in patients with hematuria. In 2005, Sarosdy stated; “This… should allow physicians to make an earlier diagnosis, with earlier treatment” (p. 1). Hajdinjak (2008) identified and reviewed 14 research articles that included the FISH assay as a tool used in diagnosing bladder cancer. Synthesizing the results of these studies reveals that the sensitivity of FISH ranges from 69% to 75% (mean 72%), and the specificity ranges from 82% to 85% (mean 83%). The overall performance for FISH was higher than that obtained using cytology, yet these differences almost disappear after superficial cancer cases are excluded. This author states that a positive FISH result moderately increases the probability of the presence of any stage of bladder cancer, and a negative result reduces this probability by a small but significant amount. Thus, while the FISH test results cannot provide conclusive evidence for the presence or absence of cancer, both positive and negative results should influence the probability of the disease. Ferra and associates (2009) evaluated the effectiveness of FISH among 161 patients with suspicious cytology results. The aim of this study was to identify those for whom an aggressive work up was indicated. These results indicate that a negative FISH test did not rule out the presence of a low- or high-grade cancer when the urine specimen was suspicious. Thus, these authors conclude that an aggressive work up is not indicated when patients display a suspicious cytology, positive FISH result, and a negative cystoscopic evaluation. Research has demonstrated the clinical value and diagnostic significance of FISH, but these findings are not universal nor considered confirmative as yet. Wild and colleagues (2009) state that the FISH test is capable of detecting symptoms of malignancy on the molecular level. This may lead to earlier diagnosis and therapy, and it may potentially extend survival. FISH makes it possible to make decisions in cases of atypical or unclear cytological findings. According to Reid-Nicholson and colleagues (2009), FISH results cannot be used to definitely diagnose squamous carcinoma or adenocarcinoma, nor can it be used to differentiate the two from urothelial carcinoma. However, it may be useful as a surveillance tool in established primary and secondary bladder adenocarcinoma. When urine specimens are suspicious, the role of FISH is questionable, especially in light of the high cost associated with this test. According to the AUA (Hall & Chang, 2007), cystoscopy remains the gold standard in the diagnosis and surveillance of bladder cancer.”

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Is fish test more accurate than cytology?

This is the way it was explained to my from Dr. Smith at Vanderbilt University. A cytology is very accurate, which means when it comes back positive, it rarely has false positives. A FISH test on the other hand, will have more false positives. I did not hear that FISH tests are pretty accurae at detecting high grade. But, that is just because I haven’t heard that. JJ is really the expert on all this so maybe he can explain things a little better. Katy

Is a blue light cystocopy accurate?

even the blue light cystocopy is not accurate. The Uro cleared my husband after blue light cysto but biopsy came out positive. RC said T2.

Is a fish test a predictor of cancer?

I had a couple of FISH tests and both came back negative yet the biopsies that were done were positive. For me, the FISH test was not a valid predictor of whether cancer was present. This all happened about 6 years ago, though, I must say. Nancy in CHarlotte

Do urologists give false positives?

They do give false positives sometime and they are the most accurate test they have but not full proof. Believe me I know as I had about four or five of them and they came back negative, then positive, then positive, then negative, then they took my bladder out to be safe and bingo it was cancer.

Summary

Diagnosis

• Because a FISH test can detect genetic abnormalities associated with cancer, it’s useful for diagnosing some types of the disease. When the type of cancer has previously been diagnosed, a FISH test also may provide additional information to help predict a patient’s outcome and whether he or she is likely to respond to chemotherapy drugs.

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