What is bladder cancer - and how is it treated?/Walla system
Breakthrough in cancer diagnosis: The Ministry of Health recently approved a new test that makes it possible to assess the risk of the presence of cancer in the bladder with a high level of accuracy.
This is a simple urine test that is part of the category of liquid biopsy for the early diagnosis of cancer without an invasive procedure.
The test is based on the identification of biological markers (biomarkers) on the DNA extracted from the cells in the urine sample. The presence of these markers indicates an increased risk of having a cancerous tumor, even one that sometimes cannot be seen at all in invasive imaging or diagnostic tests.
Bladder cancer It is the fifth most common in Israel and today there are approximately 20,000 Israelis who are in the stages of treatment, recovery and follow-up. According to the estimate of the Cancer Society, each year approximately 1,800 patients and new patients are diagnosed in Israel. According to the Ministry of Health, approximately 50% of the cases are among women and men who smoke.
The new test will enable initial diagnosis among those with suspicious symptoms as well as the diagnosis of recurrence of the disease in those who have already recovered, for whom the risk of recurrence of the disease is high and stands at 40-70 percent of the cases. Until now, follow-up has been done through an invasive cystoscopy test that includes the insertion of a tube with optical fibers into the bladder through the opening of the urethra. Sometimes, this test is performed under anesthesia. Because of the tumor's tendency to return, patients who have previously been diagnosed with bladder cancer and operated on, are required to undergo a significant number of invasive tests as part of the follow-up over many years.
"Early diagnosis of bladder cancer is the key to cure."
A new urine test to detect bladder cancer/ShutterStock
Bladder cancer is one of the most challenging and expensive types of cancer to diagnose, treat and monitor.
In fact, it is the most expensive cancer to treat because of the need for follow-up for many years and several times a year.
The new test called Bladder EpiCheck is designed to identify the presence or absence of bladder cancer in the patients' urine samples.
The use of this test will allow a reduction in the number of invasive tests for patients under follow-up, by using the new test alternately with cystoscopy tests.
In addition, the test may improve the early detection rates of the tumors, in particular flat tumors that are difficult to locate with an invasive test or imaging.
"Early diagnosis of bladder cancer is the key to a cure," says Prof. Ofer Nativ, an expert in urological surgery, a lecturer at the Technion's Faculty of Medicine, former director of the urological department in Bnei Zion and a scientific advisor to the manufacturer of the new test.
"The test is a significant innovation that allows us as doctors to diagnose tumors that are sometimes difficult to see with the existing tests as well as to increase the invasive cystoscopy tests in patients who are under follow-up. Naturally, most people shy away from the invasive tests and therefore in many cases refrain from performing the follow-up as often as required. The simple urine test will increase the compliance rate for follow-up and reduce the discomfort associated with an invasive procedure.
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The urine test will save you the suffering of the existing invasive test
"Another application of the test is for patients who have developed symptoms suspicious of bladder cancer, mainly bleeding but also burning during urination. In the vast majority of them the cause is not a tumor, but in order to rule out cancer, in most cases the patients are also required to undergo an invasive cystoscopy as part of the investigation process. Use The new test, also in the application of initial diagnosis, will enable a significant reduction in the number of invasive tests.
"Naturally, most people shy away from invasive tests and therefore in many cases avoid performing follow-up as often as required. The simple urine test will increase the compliance rate for follow-up and reduce the discomfort associated with an invasive procedure"
"Early diagnosis of bladder cancer, and in particular tumors with a high degree of malignancy, is of great importance, due to the fact that these tumors may progress rapidly, penetrate the muscle tissue of the bladder wall and also spread to the lymph nodes and other organs. Thanks to the information obtained from the new urine test, it is possible to refer to an invasive procedure only Those who are being tested as positive for cancer and not those who are only suspected as such."
The effectiveness and reliability of the new test were recently proven in an extensive meta-analysis of international clinical studies conducted in several medical centers around the world, which indicated that the test improves the detection rate of cases with urinary tract malignancies.
The studies showed that the test has a negative predictive value of 99% for cancer with a high degree of malignancy in the bladder, meaning that in 99% of the cases in which a negative result is obtained, there is indeed no cancer with a high degree of malignancy in the bladder.
The test is expensive - but there is usually a refund
The test was developed by the Israeli company Nucleix, which specializes in non-invasive molecular tests for cancer diagnosis.
It has been approved by the American Food and Drug Administration (FDA) for the diagnosis of disease recurrence and is even included in the tests reviewed in the guidelines of the European Association of Urology (EAU).
In addition, it has the CE mark for European standardization and saves manpower, infrastructure and costs for the health system.
The test is intended for men and women of any age with suspected bladder cancer who have a referral from a urologist.
Its cost is NIS 3,250 and as of today it is already included in most private health insurances in Israel.
In addition, Klalit members with perfect insurance receive a refund of 75% of the cost (under the category of a second opinion abroad) and it is estimated that soon other health funds are also expected to join the arrangement
. Through a courier of the sample from their home. The samples are sent to a laboratory in the Netherlands for decoding, and the answer is received within about 15 days. In addition, the subject receives a more detailed risk assessment for professional review by the attending urologist.
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Bladder cancer
diagnosis
Urine Test