Home Forums All Categories Articles of Interest Urinary cytology for the detection of BLC

  • mmc's avatar

    mmc

    Member
    April 6, 2011 at 12:11 pm

    Not sure I understand the point of the study or the conclusion.

    Says that cytology is flawed adjunct to cystoscopy.
    It could just as well have said that a cystoscopy is a flawed adjunct to cytology.

    Both have flaws (false positives and false negatives).

    Seems that a bladder wash is a good idea for the cytology. I’m pretty sure that is when mine was caught. I got cytologies at every cysto so it seems as thoughe the one I had a couple of months before my recurrence would possibly have shown something if it had not been just voided urine. Who knows.

    If you have a urologist who says he/she doesn’t want to bother with a regular cytology on your schedule of follow up cystos, I’d suggest insisting on it. They can’t always see the problem with the scope (as evidenced by my situation). Mine had become invasive and it was not seen with the scope. Had it not been for the cytology… (Actually, I wouldn’t have believed it even if the cytology had been negative. I know that blood clots are not normal and with a history of bladder cancer I would have gone for a cysto and sampling at University of Colorado hospital or at MD Anderson).

    If you know the tests can be flawed, and common sense tells you that peeing blood and clots is a reasonable sign that you have a recurrence–you have to be like a dog with a bone.

    I have faith in doctors but they aren’t the ones who die if they are wrong. Of course it is just my opinion, but I want all the tests that will increase the probability of detecting a recurrence (prior to progression).

    Mike


    Age 54
    10/31/06 dx CIS (TisG3) non-invasive (at 47)
    9/19/08 TURB/TUIP dx Invasive T2G3
    10/8/08 RC neobladder(at 49)
    2/15/13 T4G3N3M1 distant metastases(at 53)
    9/2013 finished chemo -cancer free again
    1/2014 ct scan results….distant mets
    2/2014 ct result…spread to liver, kidneys, and lymph system

    My opinions are my own and do not reflect the opinion of ABLCS or anyone else. I am not a doctor nor do I play one on TV.
  • mmc's avatar

    mmc

    Member
    April 6, 2011 at 11:54 am

    Yes, it can come back positive when they see nothing with the cysto. It can happen quite often. That’s why they came out with the blue light scope (to see anomalies better).

    My recurrence was not seen with the cysto. I had my regular cysto which showed nothing. A month or so later I started peeing blood clots, flew home for an immediate follow up cysto. Saw nothing. My local uro thought it might be in the kidneys since he saw nothing in the bladder. Went in for TURB (random samples of the bladder) and cytology of kidneys and bladder and the cytologies all came back positive for high grade recurrence.

    Luckily, the kidney cytologies were contaminated (even though my local uro said he was VERY careful getting the samples). You have to go through the bladder to get to the kidneys to draw urine (both going in and coming out).

    Went to MD Anderson and the doctor there said that having it go to both kidneys like that was so rare and that it is so hard to get a clean urine sample from the kidneys that he just wouldn’t count it at all.

    Then I went to University of Colorado hospital for a follow up and they found the spot in my bladder and it was invasive. They also did ureter and kidney sampling and they were all clear.

    (Notice that I practiced what I preach by getting a 2nd and 3rd opinion from major bladder cancer specialists).

    The cytology is a very important part of the follow up monitoring!

    Mike


    Age 54
    10/31/06 dx CIS (TisG3) non-invasive (at 47)
    9/19/08 TURB/TUIP dx Invasive T2G3
    10/8/08 RC neobladder(at 49)
    2/15/13 T4G3N3M1 distant metastases(at 53)
    9/2013 finished chemo -cancer free again
    1/2014 ct scan results….distant mets
    2/2014 ct result…spread to liver, kidneys, and lymph system

    My opinions are my own and do not reflect the opinion of ABLCS or anyone else. I am not a doctor nor do I play one on TV.
  • cynthia's avatar

    cynthia

    Administrator
    April 6, 2011 at 12:11 am

    I actually talked to a woman that is dealing with just that happening.

    I was stage 2 it was very aggressive and never had a positive cytology go figure.


    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
  • DougG's avatar

    DougG

    Member
    April 5, 2011 at 11:51 pm

    Wonder if the cytology report ever comes back positive when no bladder cancer is detected during the scope?


    Anita
    Forum Moderator
    Caregiver

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