a) FISH is not definitive, only one tool before proceeding to a more invasive procedure. I have had some false positives that have been borne out by cystos and biopsies.
b) Second opinions nerver hurt, but the cysto should tell you one way or the other - I would have the cysto before seeking options unless you are uncomfortable with your urologist (uro). There may be nothing, might be superficial, etc.
c) No experience
Hope this helps and good luck. Thinking about the cysto will definitely be worse than the procedure.
TaG1 March 06
Recurrence Jan 07
BCG Maintenance after 6 week treatment
Hello BMU and welcome to the site - wish that it could be under better circumstances. Hopefully, some of the other users on the site will be able to provide you with their thoughts and opinions. You mention that you have an upcoming appointment with your urologist. Once further tests have been performed, you'll have much more information, including various treatment options. If you've looked at any of the information on the site, you'll see that there are two categories: invasive and non-invasive.
Since the treatment options are very different between the two, you won't be able to consider which to select until you know whether or not it's invasive or non-invasive. Unfortunately, urine cytology tests can't determine invasive or non-invasive without further tests.
The cystoscopy is usually performed in a office and does involve a flexible or rigid scope inserted into the bladder. The other common test is is a TURB that's performed as an outpatient procedure in a hospital or medical center. The TURB involves the use of a scope, but it can used to remove tissue for further study as well as remove tumors if they're found.
Once you've seen your doctor, please let us know what you learn and hopefully we can provide further thoughts.
Edward J. Kinsella
American Bladder Cancer Society
Board of Directors - Secretary/Clerk
10 years 6 months ago - 10 years 6 months ago#23896by Moonerj
Welcome to our community. This is a great place to assist you with your current situation.
There is no need for another opinion until your current Uro inspects your bladder. Blood in the urine is one of the signs of bladder cancer.
There is no danger in the procedure which we all call a cysto.
There is no pain at all in the procedure either.
Until he inspects the bladder for tumors, the urine tests are not 100% conclusive.
So go ahead and have the procedure. The procedure will determine if you in deed have bladder cancer. He will take biopsies and have them send to the lab for testing.
Your have come to a very good site. All of us have had this procedure to determine if we had BLC. So keep us posted on how you are doing.
Best of luck,
TA Grade 1
30 BCG Treatments
Cancer Free since Nov 2007
Hello Everyone, I am writing to see if anyone can help with the interpretation of my test results and case history so far. About 6 weeks ago, I saw the Urologist regarding a slight, persistent swelling in the right testicle. He said it was probably caused by inflammation and advised me to cut down on exercise (which I was doing about 5 days a week). However, during the routine strip testing of the urine, he said there were traces of blood in the urine (though it was not visible at all) and ordered an ultrasound which revealed a 4 mm stone. He immediately scheduled a shockwave treatment to get rid of the stone---the underlying logic being that if the traces of blood persist even after the pulverization of the stone, there would be cause for concern for bladder cancer. However, in the meantime, I purchased Hemastix on my own, stopped my exercise for about 14 days and tested the urine for traces of blood on my own. The tests at home were negative for three consecutive days, and I did not know if it was due to stopping of the exercise or whether it was just random. My primary care doctor initially felt that a 4mm stone is not a big deal and would probably pass on its own. In any case, because of this and the negative test at home, I asked the Urologist whether it might be a better idea to wait for a few more weeks to see if the stone grows larger than 4 mm since I had absolutely no symptoms---no pain, no frequent urge to urinate (or any more than what I was used to) except the traces of blood detected some weeks ago by his office. Then the Urologist's office called and scheduled a urinalysis. In the meantime, I resumed my exercise, and the Hemastix strip started to show slightly positive results.
I am 59 and have been using Caverject/Edex for ED for a couple of years. It seemed that whenever the injection is used, the hemastix strip would show slightly positive result. However, when I asked the Urologist during my second visit, he said there is no connection between the two at all.
The Urologist's office called last week to schedule a visit and gave me the choice of seeing him either in the office or the hospital. I asked what the purpose of the visit was and the secretary simply said that the test showed some abnormality in cells, and so the doctor wants to take a look at it. She would not say what exactly he would be looking at, or what the abnormalities were. I requested a copy of the FISH results directly from the lab, and finally received it just two days ago. Now I am indeed fightened because the report says: "POSITIVE fluorescence in situ hybridization (FISH) result using the Vysis UroVysion TM assay... INTERPRETATION AND COMMENTS: An ABNORMAL hybridization pattern was observed with 5 cells exhibiting numerical abnormalities for chromosomes 3,7,9, and 17. This result is indicative of bladder cancer according to the UroVysion Directional Insert."
I guess that pretty much leaves little room for doubt. I am surprised that I would get this bladder cancer without any major symptoms and am worried about how long it might have been present in the bladder. I have Rheumatoid Arthritis for about 8 years for which I take Enbrel injection and Salagen for dry mouth.
My appointment with the Urologist is coming up in 2 days and from past experience, I know that he does not like to talk much, but pretty much tends to summarize things in two or three minutes. I am concerned about having to make a decision about something on the spot. What do you think I can expect during this visit? From what I have read so far, it appears that I can look forward to his inserting a flexible or rigid tube through the penis. Following are my questions:
a) Is there a risk in this procedure? Should I insist on a second opinion now before any futher exploration is done?
b) Are there alternatives that I should ask him to explore first? Or is the FISH result so overwhelmingly definitive that I should not waste any more time and ask him to go ahead and even take a biopsy if necessarry?
c) Further, could there be a link between the use of Caverject (and possibly injecting it wrongly a couple of times over the years) and bladder cancer?