Fluorescence urine test spots bladder cancer earlier

18 Apr 2014

US company Skyline Urology says simple optical urine test identifies disease signs.

A specialized urine test can detect bladder cancer by as much as three to six months earlier than an invasive cystoscopy procedure. Specialists at Skyline Urology, based in Los Angeles, Ca, USA, are urging individuals who are at risk for bladder cancer to undergo the urine FISH (fluorescence in situ hybridization) test.

The test requires a urine sample and involves the mapping of genetic material in human cells, including specific genes, in the laboratory. Fluorescent dyes used in this test can detect genetic abnormalities linked to cancer. These findings can help physicians diagnose bladder cancer at an earlier stage, when treatment might be more effective.

"Because this test is capable of detecting up to 95% of aggressive, high-grade bladder cancers, Skyline Urology wants individuals who are at risk for bladder cancer to be able to take advantage of this important, non-invasive diagnostic tool," says Dr. Alec Koo, Skyline Urology's managing partner.

The primary indicator or symptom of bladder cancer is blood in the urine, which is often detected first on a routine urine analysis test and may not be seen by the naked eye. Alternatively or in addition, a cystoscopy is commonly used to diagnose or rule out bladder cancer. In this procedure, the urologist will place a small fiber-optic cystoscope through the opening of the urethra and into the bladder so that the doctor may see the bladder lining. If an abnormal area or growth is seen, it will be biopsied.

Cystoscopy can be performed in a doctor's office or in the operating room. A local anesthesia may be used to numb the urethra for the procedure. If a general or spinal anesthesia is used, the procedure is done in the operating room.

"In contrast, the urine FISH test requires only a simple urine sample that is processed in the lab, without the risk and discomfort involved in a cystoscopy procedure," says Dr. Koo.

While advocating for the use of the urine FISH test among patients at risk for bladder cancer, Dr. Koo points out that some individuals may be confused about the cost. "The FISH test uses the latest molecular biology technology and is the first DNA testing used to detect cancer with only a sample of urine," explains Dr. Koo.

"The cost for such testing is higher than standard urine tests because of the sophisticated technology involved. However, when compared to other tests used to diagnose urinary cancer -- such as CT scan or cystoscopy with anesthesia -- the cost of FISH testing is comparable or lower, especially considering the possibility of lost work time following anesthesia."

Risky lifestyles

Those at risk for bladder cancer include individuals with a history of smoking and those with type 2 diabetes who have taken the medication Actos for two years or longer. Exposure to certain industrial chemicals also has been linked to bladder cancer. Smokers who work with cancer-causing chemicals have an especially high risk of developing bladder cancer.

Caucasians are about twice as likely to develop bladder cancer as African Americans, and the risk of bladder cancer increases with age. About 9 out of 10 people with bladder cancer are over the age of 55. Bladder cancer is more common in men than in women, and chronic bladder irritation and urinary infections have been linked to bladder cancer.

About the Author

Matthew Peach is a contributing editor to optics.org.