Analyzes and examinations for bladder cancer

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Diagnosis of bladder cancer involves all sorts of procedures. Due to the hard work of scientists, some of the studies are capable of detecting an insidious disease on early stages and determine the type of neoplasms, as well as monitor the treatment and prevent relapses. Since the latter occur in three cases out of four, people at risk should be checked regularly for bladder cancer and tested.

What tests for bladder cancer are the most objective for today?

To date, the most reliable tests for bladder cancer are:

Oncomarkers

Oncomarkers are substances (mostly proteins or their derivatives), most often the products of the vital activity of cancer cells. Some of the cancer markers show only one type of cancer, others - several at once.

If you suspect a bladder cancer, a person gives a urine test for the UBC (Urinary Bladder Cancer). If a tumor develops in the body, the concentration of cytokeratins will be increased. The UBC indicator is so sensitive that it shows abnormalities, even when there are no symptoms of a tumor, and the patient thinks that it simply has cystitis. Until the assay, urine should be in the bladder for at least three hours.

To ensure that the diagnostic results are as accurate as possible, as a rule, several oncomarkers are examined at once. In addition to UBC, the levels of NMP22 (more often to control the effectiveness of therapy), TPS and BTA are determined. NMP22 is a specific protein, the amount of which is checked in order to monitor the effectiveness of therapy, TSP is a tissue polypeptide, most commonly found in patients with cancer of the bladder, breast, ovaries and gastrointestinal carcinoma. The BTA marker is not so valuable in diagnosing a tumor of the bladder, so almost no one has used it. In later stages of cancer in the urine, the presence of the following markers is fixed: CEA, CA 125, CA 19-9 and TPA.

The accuracy of diagnosis with oncomarkers is 86 - 87%, so this analysis is always carried out in conjunction with other studies.

Genetic predisposition analysis

For a long time, scientists have investigated a genomic sequence that points to markers associated with the risk of developing a cancerous tumor in the bladder. Until recently, two genotypes of organ cancers were known: NAT2 of slow acetylation and GSTN1. Other options are PMS2-rs6463524 and CD4-rs3213427. According to geneticists, people who inherited these genetic variants will most likely suffer from cancer of the bladder, pancreas and prostate. In addition, one in three patients with this type of cancer will inherit this genotype in 75% of cases.

At the moment, researchers are developing a genetic test that identifies patients who can be effectively treated with the PSCA antigen.

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Effective use of immunotherapy, but only in the early stages of the disease. This will help stop the spread of invasive cancer throughout the body.

Biopsy

An extremely important method of diagnosis of bladder cancer, because it excludes the possibility of an erroneous diagnosis. The procedure involves the introduction of a resectoscope through the urethra and the sampling of the neoplasm (although in some cases it can be completely removed at once). The laboratory determines the stage and degree of malignancy of the tumor, as well as its distribution and depth of penetration. Typically, a biopsy is performed in parallel with cystoscopy.

Cystoscopy

This examination of the internal surface of the organ with the help of a miniature chamber at the end of the inserted tube. A clear image on the computer screen gives the doctor the ability to detect even small and hard-to-reach tumors, and also to take tissue for biopsy.

Cytological examination of urine

The purpose of this study is to identify pathologically altered cells secreted with urine. The analysis of the biological material (urine) is carried out after its centrifugation. The results of the test are highly likely to diagnose bladder cancer, but in the early stages of the disease the results of cytological research are most often negative, which indicates the imperfection of this method diagnostics.

Ultrasonography

Ultrasound is considered an analysis with high accuracy of results. Examination of the urinary organ by ultrasound gives the doctor the opportunity to detect not only a tumor, but also to find out the reasons for the impossibility of outflow of fluid from the kidneys into the bladder, as well as bleeding and an increase in the prostate glands.

Computer and magnetic resonance imaging

These are modern methods of investigating organs, which make it possible to obtain their three-dimensional images. Tomography is a more advanced method of diagnosis than ultrasound, because it allows Obtain images of the transverse and longitudinal sections of the organ and detect even small neoplasms.

General urine analysis

This is a basic study, because in the presence of a cancerous tumor in the bladder, urine often contains impurities of blood. But to see it is not always possible, so urine is checked in the laboratory. Sometimes the presence of blood cells in urine is the only sign of an oncological disease. Also, this analysis on bladder cancer reveals the presence of infection.

Other tests

If the attending physician suspects that there are metastases, the patient will undergo additional studies:

  • Chest X-ray;
  • colonoscopy;
  • rectal palpation;
  • scintigraphy.

Symptoms required for the assignment of these analyzes

If the patient has the following symptoms, the doctor directs him to take the tests:

  • hematuria - the presence of blood cells in the urine;
  • dysuria - difficulty and pain when urinating;
  • pain in the lower abdomen, lower back and zone above the pubis;
  • weight loss;
  • weakness;
  • signs of cancer intoxication (dryness and pallor of the skin, their cyanotic shade, decreased appetite, nausea and vomiting, stool, fever, headache and dizziness, arrhythmia, anemia, propensity to thrombosis, decrease immunity).

How can I prepare for my test for bladder cancer? What do you need to know?

Collection of urine on the oncomarker:

  1. Surrenders no earlier than 3 hours after the last urination.
  2. It is best to take the morning urine.
  3. Before collecting urine, it is necessary to conduct hygienic procedures.
  4. The intake of diuretic drugs is excluded the day before.
  5. Women are not recommended to take urine during menstruation.
  6. The container for urine must be sterile and tightly closed.
  7. Biopsy: no special preparation is required. It is recommended to undergo the procedure on an empty stomach.
  8. Cystoscopy: For several days before the test, you need to use local anesthetics (injected parenterally). 8 hours before the procedure, you must give up food, in a few hours - empty the intestines. In addition, before cystoscopy it is necessary to conduct hygiene of the external genitalia.
  9. Ultrasound: only with a complete bladder. You can not urinate in the morning before the test, or for an hour or two before ultrasound to drink a liter of liquid (without gas or milk).
  10. CT and MRI: as in the case of ultrasound, the procedure is performed only with a complete bladder.

Approximate cost of analyzes

Study

Cost in Russia (rubles)

Cost in Ukraine (UAH)

General urine analysis 270 - 450 80 - 100
Ultrasound 900 - 1500 120 - 200
Cystoscopy 4500 - 5500 1000 - 1500
Biopsy 32000 - 60000 4500 - 11000
Oncomarkers 1300 - 1800 280
Genetic markers 4000 - 5000 1000

When should I see a doctor?

It is necessary to make an appointment with the urologist at the first signs of hematuria. The appearance of blood in the urine and even minor pain in the lower abdomen is an occasion to contact the medical institution as soon as possible.

Modern diagnostic methods allow early detection of bladder cancer. Analyzes and studies conducted in medical institutions are improving every year and become more accurate, and therapy is more effective. The main thing is prevention, which consists in regular check-ups (especially those who are at risk) and maintaining a healthy lifestyle.

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