Abnormal cells

And...as Rosie and I found out from Dr. O'Donnell, there can be different degrees of aggressiveness seen in the cells from urine tests, which can give an idea of the 'grade'. Something you might want to ask as well.
Wendy

Thanks for the info, I am making aseperate post as to waht Uro Doc said today. Don

Wendy and Don,

There are some existing guidelines at LABCORP for urine cytology. I posted them in December when I went for a second opinion at my primary care physicians office. Here is the link to that thread that tells other circumstances that can adversely affect the accuracy of a urine cytology. Rosie blcforum.com/smf/index.php/topic,598.0.html

Don,

Good luck with the FISH on Monday and any decision you have to make regarding your situation - I know how difficult it is. I had a neg cysto and pos FISH. Lab documentation recommended looking for cancer elsewhere. I had previously had the IVP's and CT scans for the upper UT and all were negative. However, I followed doctor's advice to get biopsies from kidneys, ureters, and prostate (all negative also). Everything took about 5 weeks to complete and I only missed about 5 days of work during the entire period. Thinking about the procedures was definitely worse than the procedures themselves.

My advice is to just do your research and make a decision that is good for you - when you look back you don't want to have any regrets about anything you did or didn't do. It seems like everyone's experience is a little different.

Moreover, when I was trying to decide on mitomycin or BCG, I read somewhere that mitomycin should not be used in the absence of cancer. Probably a good decision to hold off here (plus there are some possible negative side effects).

Hope this helps and that all of your tests return negative - it will certainly make your choices easier.

Hi Don,

Cytology can be repeated, and needs to be done before any cystos as this can mess up results. There are also different 'grades' of cells that come back with the results, and cytology can show it if it very aggressive, or mildly aggressive.

Guidelines for cytology are sorely lacking and it's common for mistakes to be made as the urine is sent out to an outside lab, and the test is also subjective like pathology is.

The same might go for FISH, that is shouldn't be done too near a cytoscopy which might give false positives= I'm not 100% sure about this though. I can find out for you if you need. It is looking at genetic abnormalites, so maybe it is not affected by inflammation...good chance.

For the record, here is the closest thing to guidelines about cytology tests that we have as of now, I received them from the author in the UK:

Urine for cytology should be the second morning voiding collected directly into a clean container. Approx 20ml is suggested as an optimum volume although smaller volumes are also acceptable for processing by the lab. Samples collected on 3 separate days may increase the chance of detecting abnormal cells.

A fixative may be used if delay in transport is expected, say over a weekend, and refrigeration at 4 degree C is not available. Collection into special fixative may be necessary for UroVysion testing.

Guidelines on urine cytology are being published by the British Society for Clinical Cytology (BSCC) and may become available in a few months. I am not aware of any other existing guidelines on this subject.

Hi Wendy: Thanks for your reply. I went to have the hole kidney exray thing done today with a cleanout last night and a contrast fluid injected today. When I go to Uro Doc Monday if all is well with the kidneys and all that. I will ask for a fish test to nail it down. Untill all this is done we will not do any treatments. I am hoping and praying there is nothing wrong with Kidneys or anything else. Thanks again From Don