A novel and highly sensitive test for diagnosing and monitoring bladder cancer comes from investigators at Stanford School of Medicine. It’s designed to look for fragments of cancer DNA in urine and can detect the disease in its early stages of development.
“This study describes a new diagnostic approach to bladder cancer focused on the analysis of urine samples”, explained Maximilian Diehn, MD, PhD, associate professor of radiation oncology. “Urine is in direct contact with bladder tumors, which shed some of their DNA into it.”
According to the American Cancer Society, bladder cancer remains one of the most common forms of malignancy, affecting more than 80,000 people each year. At the moment, the most accurate form of detection is through cystoscopy, an invasive method to visualize the bladder and take tissue samples. Another option is a cytology test, noninvasive though also not very reliable.
This new approach is based on searching for DNA fragments of tumors circulating in the bloodstream using a method called CAPP-Seq (cancer personalized profiling by deep sequencing).
The team examined a total of 67 healthy adults and 118 patients with early stage bladder cancer and found markers that allowed for early detection, when the disease can be treated more easily. It could determine the presence of bladder cancer in 83% of patients with early stage onset, compared with only 14% for the clinically available urine cytology test.
Among the benefits, this new test can provide is the ability to detect the recurrence of bladder cancer after someone has been treated for the disease. “In our test samples, we were able to detect bladder cancer recurrence an average of 2.7 months earlier than could be done with cystoscopy”, noted co-author Ash Alizadeh, MD, PhD, associate professor of medicine.
Researchers are confident that this method of looking for cancer DNA in body fluids other than blood could be more widely applied. “It may eventually be useful for testing saliva for oral cancer, cerebrospinal fluid for neurological cancers or sputum for lung cancer”, added Dr. Diehn.
Diagnosing the disease early on can make a great difference. Survival rates can go from 98% for those with initial stage bladder cancer as low as 15% in advanced cases where the disease has spread.
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