Diagnosis

Bladder cancer

Diagnosis of bladder cancer

Seventy-five percent of bladder cancers are diagnosed at a non-muscle invasive stage, that is, when the root of the tumor has not reached the bladder muscle. This allows us to preserve the bladder in most patients by applying a series of adjuvant treatments. Even so, they will need continuous revisions due to the recurrent and progressive nature of the tumor.

For the diagnosis and follow-up of bladder cancer, several complementary tests are performed:

1. Blood test

2. Urinalysis

3. Urinary cytology

It consists of the anatomopathological evaluation of the bladder cells that are shed in the urine.

4. Imaging tests

Imaging tests such as ultrasounds, scans or cystoscopies, which consist of the introduction of a camera (cystoscope) through the urethra for direct vision of the inside of the bladder. The latter is more invasive and uncomfortable for the patient.

5. Bladder Epicheck® Bladder

As an alternative, we have a non-invasive test available: the Bladder Epicheck® DNA methylation test, which reduces the intensity of cystoscopies and the need for these invasive tests. It is a convenient test for the patient, as only a urine sample is required.

The Bladder Epicheck® epigenetic kit is a PCR test that analyzes DNA present in urine and studies DNA methylation of 15 specific markers of bladder tumors. If the result is negative, the test rules out the presence of aggressive bladder tumors with more than 99% accuracy.

6. Analysis of risk factors

In the diagnostic process, we ask the patient if he/she has any risk factors for bladder cancer such as smoking or exposure to chemical agents.

7. Anatomopathological evaluation

If a tumor is found, we must observe its size, number, location, appearance, level of invasion and cellular grade. In addition, in this anatomopathological evaluation we conclude whether the tumor is non-muscle-invasive, that is, it has not reached the detrusor muscle of the bladder, or if, on the contrary, it is muscle-invasive, that is, its roots have reached the muscular layer (25%). Depending on this, one treatment or another will be applied, allowing the bladder to be preserved in almost all cases of non-muscle invasion or forcing us to perform a cystectomy (removal of the bladder) in most cases of muscle invasion.

8. UroTAC

UroTAC is also performed to evaluate the ureters, pelvis and renal calyces and to rule out the presence of tumor implants in these locations, since upper urinary tract tumors can coexist with bladder tumors in up to 5-10% of cases. UroTAC is a radiological procedure that produces three-dimensional cross-sectional images of the human body. As with other imaging tests, intravenous contrast is used. This helps to better delineate anatomical structures, such as the body's blood vessels. In addition, thoracoabdominal pelvic CT is used to rule out the presence of metastases.