Hello all -- this seems like a very helpful forum, and I'm glad I found it.
I had a routine urinalysis in March which showed microscopic hematuria, confirmed a few times while I was seeing my gynecologist for post-menopausal treatment which reduced the lab results of blood in my urine (not visible to me) from "large" to "trace." Pelvic CT showed no kidney stones, proceeded to urologist for cytoscopy which showed nothing abnormal. Urologist said to come back in 6 months, and I left another urine sample for cytology. "Atypical cells," repeat urinalysis (at my convenience they said). I did that today and saw the lab order: FISH. I had no idea what that was, until I looked it up. Ugh.
I realize there's no point in getting worked up until I receive more information, but I'm wonder how often cytoscopy is normal, yet something is there. I have no symptoms, just the history of hematuria...
Take a deep breath! There are a lot of reasons for hematuria other than bladder cancer!
Your urologist is doing "due diligence" by ordering cytology tests on the urine sample. FISH is a relatively sophisticated one that is done along with just looking at the cells present. However, just a word of caution....the FISH test is very sensitive, which means that sometimes it shows abnormalities which turn out NOT to be cancer. When the results come back, if there ARE abnormalities it does not necessarily mean that you have cancer. Your urologist would then probably do a biopsy just to make sure. Until the results of a biopsy are in hand no one can tell for certain.
As for having bladder cancer when the cystoscopy looks normal, there are forms of bladder cancer which are more like irritation on the bladder lining and are sometimes not obvious.
I know that it is hard, but try not to worry. Doing a FISH test and other cytology is just a double check to see that everything is normal.
Please let us know how this turns out!
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Thank you Sara Anne! My head was telling me that I was not high risk, but this is all new territory for me.
So the SIXTH urinalysis came back no hematuria and cytoscopy, 3rd cytology (including FISH) was negative. So all you menopausal women out there, take heart that microscopic blood in the urine could be related to menopausal inflammation of the surrounding tissue. I will get rechecked in 6 months though.
I wish you all the best! And thank you for allowing me to be a part of your forum. Kate B