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sensitivity of urine cytology to bladder CIS

3 years 2 months ago #49359 by Cynthia
Just Me, We are not doctors here and no one but a doctor will be able to give you a difinative answer. Cytology can be of great value but also has a certain percentage of faults negative and positives. The only way to firmly diognois any cancer is trough microscopic analysis following biopsy.

Blood in the urine can be one of about 1000 things and in some cases the answer is never found and no harm is done. You do have other symptoms and I can understand your stress with the situation you want answers and do not feel you are getting them. But the truth is that posting questions and reading everything you can will not get you the answers you need and will only lead to more stress. You have to stop looking for answers on the Internet and get to a center of excellence for Urological care. This forum is here for caregivers and survivors to share support we can not diognois you that is not its purpose. Please find a doctor you trust and get to the bottom of this.

Good luck

Cynthia Kinsella
T2 g3 CIS 8/04
Clinical Trial
Chemotherapy & Radiation 10/04-12/04
Chemotherapy 3/05-5/05
BCG 9/05-1-06
RC w/umbilical Indiana pouch 5/06
Left Nephrectomy 1/09
President American Bladder Cancer Society

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3 years 2 months ago #49355 by OldEngineer
Needless to say I defer to your doctors, but my understanding from my discussions with the docs I am seeing is that to be detectable by cytology, there has to be cells shed into the urine, and CIS may or may not shed cells, hence normal cytology results do not necessarily mean there is no CIS. But again, I defer to your docs or to others on the forum who are more knowledgeable than I. Good luck to you - hope all turns out well for you!

T1 high grade transcell diagnosed 8/14/2015
TURBT 8/21/2015, removed tumor (17mmX14mmX11mm)
Repeat TURBT performed 9/25/2015
Pathology Report: no residual cancer detected
BCG planned starting in October

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3 years 2 months ago #49353 by just_me36
my cystoscopy was normal also.
as far as i know, high grade tumors like CIS cannot be seen in cystoscopy and that is why cytology is done which is sensitive to high grade.
cytology is not sensitive to low grade but cystoscopy is sensitive.
that is the reason why they do together.
this is what i have read but i am not sure if it is correct and that is why i am asking here.

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3 years 2 months ago #49352 by OldEngineer
I recently asked a very similar question of my urologist and separately a pathologist at Sloan Kettering because I wanted to know what predictive value urine cytology has - e.g., could I avoid a cystoscopy? From what they told me, cytology can be useful if there are cancer cells in the urine itself, but often times the urine contains what are just called "atypical" cells which means cells with unusual nuclei ("hyperchromatic") which could be precancerous or just normal for you. And if the urine contains nothing abnormal that does not mean there is no tumor or growth - just means whatever is there may not be shedding evidence into the urine. Doing a one-time cytology study thus may not tell you much; doing the same study over time does allow changes to be detected and that is more useful. But bottom line is that cytology is almost always done in conjunction with other techniques to help refine the diagnosis.

All that having been said - please understand that is my interpretation of what the doctors told me; not being a doctor myself, of course I encourage you to talk to your doctors who are the experts in your specific situation. Good luck to you!

T1 high grade transcell diagnosed 8/14/2015
TURBT 8/21/2015, removed tumor (17mmX14mmX11mm)
Repeat TURBT performed 9/25/2015
Pathology Report: no residual cancer detected
BCG planned starting in October

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3 years 2 months ago #49351 by just_me36
My sympyoms over 3.5 month:

burning and frequent urination, blood in urine from time to time.
My cystoccopy was normal and cytology negative.
I did ultrasound of bladder and it was normal also.
I think it is possible that CIS may be missed in cystoscopy and ultrasound.
What is the sensitivity of urine cytology to CIS?

Note: I am 36 years old.

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