A new technique has been designed that will hopefully aid physicians in detecting the early stages of bladder cancer. Researchers at Yale University have developed a urine test that identifies a protein that is found in bladder cancer cells.
Currently, the methods for the detection of bladder cancer rely on cytological examination of urine and a cytoscopy, where a scope is passed through the urethra into the bladder to examine the bladder walls. The cytoscopy is both expensive and painful for the patient. In a study of 158 patients, the group found that all patients with new or recurring bladder cancer tested positive for the presence of the protein survivin in their urine. All healthy patients tested negative for the protein and patients with other cancers including kidney, prostate, cervical and vaginal cancer also all tested negative for survivin.
The survival rate for bladder cancer is quite high, with a five-year survival rate of 93%. However, most patients will have a recurrence of the disease, and once diagnosed and treated, patients must undergo a cytoscopy every three months for two years to ensure that the cancer has not returned. In addition, they must have an annual upper tract study where the kidneys, urethra and bladder are examined for the presence of malignant cells.
Several other studies have investigated a marker to detect bladder cancer, and until now telomerase has been the new marker. Until a method is developed that is 100% specific and sensitive, cytoscopy will remain the only reliable method to test for bladder cancer.
People over the age of 40 are at a higher risk for bladder cancer, and men are at higher risk than are women. There is also an increased rate of this cancer in smokers when compared to non-smokers. For a full article on the diagnosis and treatment of bladder cancer in the elderly, please see next month's issue of Geriatrics & Aging.
Source
- Smith, SD et al. Urine detection of survivin and diagnosis of bladder cancer. JAMA 2001; 285:324-328.
