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What’s next - Positive FISH test..

2 months 3 weeks ago - 2 months 3 weeks ago #59506 by Alan
Soulbarn,

Welcome. Yes, as Sara Anne said the FISH test is notorious for false positives. However, with blood in the urine you certainly want to find out why. Often, blood in the urine has other causes than bladder cancer. I presume you have had a cystoscopy? The biopsy called a TURB (transuretheral resection) will give your URO some clarity with understanding it is the biopsy that is done as the key. You will not know anything until then. A CT Scan is often done to rule out other urinary tract problems.

Grade is simply low grade (slower growing) or high grade (faster growing.more dangerous tumors). Progression is how far a tumor has penetrated. Stage 0 (very early/superficial), 1 (first layers),2 (muscle invasive),3 ,4, (see this web site/menu drop downs for deeper explanations). Often a second opinion is good for fresh eyes and validation of a DX. 4weeks? I have no idea what is good now with COVID. While this is not elective in may be lower priority in hospitals. Boston may be a good start as you do want a practice or hospital that sees lots of bladder cancer.

DX 5/6/2008 TAG3 papillary tumor .5 CM in size. 2 TURBS followed by 6 instillations of BCG weekly with a second round of 6 after a 6 week wait.

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2 months 3 weeks ago #59505 by sara.anne
Sorry that you are having to worry about this. A positive FISH test does indicate that there are abnormal cells present and that further exam is warranted. However, these tests are known for frequent false positive results, which is why they are not diagnostic but rather a suggestion that further tests, such as your biopsy, should be done. This is why your urologist stated that it might not be cancer.

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator

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2 months 3 weeks ago #59504 by Soulbarn
So, I was having a lot of bloody urine. Had cytology. Atypical level 2. UroVysion FISH test “positive and associated with the development and progression of urothelial carcinoma and generally correlates with a high-grade tumor.”

My urologist has scheduled an exploratory biopsy for July 21, so about four weeks from now. Does that seem like a long time to wait (he’s booked because this is a relatively small city and everybody delayed getting treated during the Covid-19 crisis.)

Also: how positive is positive. I’m trained in plant pathology, and from what I know about genetics, the FISH test detects abnormal cells and abnormal cell activity and mutation (“aneuploidy” and “homozygous deletion” are both mentioned in my test results.) That seems pretty conclusive to me, but my urologist says it might not be cancer. What else could it be?

And: what does “high grade” and “progression” mean in context?

He didn’t do a great job of answering my questions. I’m wondering if I should try to go to Boston, two hours away.

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