Expert Review of Molecular Diagnostics
January 2007, Vol. 7, No. 1, Pages 11-19
Fluorescence in situ hybridization: a multitarget approach in diagnosis and management of urothelial cancer
Harm C Arentsen, Jean JMCH de la Rosette, Theo M de Reijke and Sigrun Langbein
† Author for correspondence
Noninvasive tests for detecting genetic or molecular alterations in urine indicative of urothelial cancer are increasingly becoming the focus of urological cancer research. Since its approval by the US FDA in 2001, the fluorescence in situ hybridization test (Vysis®UroVysion™) has been widely evaluated. In general, published data demonstrate better sensitivity and equal or better specificity compared with routine cytology, which is still considered the 'gold standard’ in diagnosing and monitoring bladder tumors. However, the fluorescence in situ hybridization test seems to provide not only a useful tool in bladder cancer detection, but also in the diagnosis of upper urinary tract tumors, surveillance and determining therapy effectiveness. This multitarget assay that detects four different chromosomal aberrations in tumor cells is a kind of objective molecular cytology and has proven advantages over routinely used cytology.
Tommy, yes Dr. Lamm has been a tremendous consulting help to myself and many others. Watch and wait seems very reasonable in considering your diagnosis. NANCY 2 1/2 mm - millimeters not centimeters. Very teeny tiny. Most of us are being diagnosed when the tumor is at centimeters rather than millimeters. I had a FISH test done a few years ago and it came back positive for cancer. I understand from others who have had it done that the FISH often times comes back as positive if there are any cancer cells present which is different from having an actual tumor. Clear as mud?!
the most important part of any decision is that you feel comfortable with it and have as many of the facts and opinions at your disposal as possible. this sites great for that. sounds to me like you feel happy with your chosen way forward and it sounds like a more considered, sensible and less sledgehammer route to me. take care and good luck.
Just a quick update on this discussion of the 12 BCG treamtments I recieved for a Ta low grade tumor. It is all so easy to follow the recomendations of a well respected URO and seems to be a great plan for further recur's. However, after reading all the discussion, I do second guess the follow up treatment. Should have? Should'nt have? After by cysto in Aug, we will be having discussions about what is next. I believe I will be on the wait and watch program.
Wendy - I did email Dr Lamm and explained my situation and he confirmed it might have been over the top and suggested I seem to have had all I should handle. It is encouraging this day and time to receive such a quick and polite reply from a DR. you have never met.
Thanks for all the input my BC friends. Tommy
I also was diagnosed in fall 06- Mine was Ta 2 1/2 mm all low risk. My URo suggested BCG (six) just as procaution. I had no side effects except the usual urgency and a little burning for a 24 hr period. When I went for a second opinion - that URO said he would not have done BCG however since it was over and all was well - it was insurance. Then my URO did a FISH test. Have any of your doctors done that? Mine came back neg - but I did not hear of it until I had it and then did some research on the FISH.
I go for my third cysto end of sept - then my doctor will decide on any more BCG.