FISH Test on urine specimen?

David,

I also had a positive FISH last summer (bladder wash). I went through the biopsies of the upper tract and prostate to rule out cancer somewhere else (all negative). What I've read about FISH is that it can also be an early indicator of recurrence. However, my last FISH (voided sample) came back negative with a negative cysto. I don't know what to make of it except for peace of mind it might be worthwhile to look at prostate and upper tract if you get a positive result with a negative cysto.

Ross

The only thing I can think of that should have been done earlier was to scope the upper tract and take biopsies. That was not done until Dick got a new urologist when we moved to Tucson. My understanding is his first urologist followed protocol by doing the IVP's and the retrograde pyelograms. I hated to be the negative voice re FISH but I think it is more sensitive to
high grade cancer like CIS than low grade papillary TCC. It is important to use both the FISH and the urine cytology. There is another test but I can't remember the name of it.

Dick is holding his own right now. He has a cysto scheduled for next month. They are looking at a new treatment for his MDS which might cure it but first it will make him miserable. Isn't that the way of cancer medication?

Julie,

That's interesting -- and a bit frightening -- I've had multiple recurrences of TA & CIS in the "Trigone" bladder neck area so there could be something going on in the upper tract. I've had a tremendous lot of inflammation since my BCG treatments last spring and continuing on through several TURBT's since then. I'll mention this to my URO doc when I go in next Tuesday for my cysto. Thanks for the info. How is your husband doing?

David

There are false positives with the FISH test but sometimes it can be an early warning to look at the upper tract. I think the different tests should be used together as they can pick up different things. My husband had a positive FISH test and then they did a retrograde pyelogram and an IVP and said they didn't find anything and his urine cytologies would show suspicious cells. His upper tract CIS/TCC was not found until last year. i suspect that prior to 2007 it was too small to be seen by the follow up examinations. His Dr. said he would not treat what he could not get a sample of and his bladder tissue showed inflammation. I am saying have them keep checking when anything comes back positive.

David,

I have spoken to top Uro's that do not use the FISH test because the results are not always correct. They still reley on the urine test (not sure of the lingo) but the one they send away to ck for cancer cells.
Let's keep our fingers crossed until we know more - don't be like me and suspect the worse. Keep the hope!

Nancy S

Thanks, Nancy

Patricia, your comment about the false positives gives me some hope. Didn't know that. However I do seem to recall that, when I had my last cysto back in mid January the doc "thought" he saw something but things were badly obscured by bleeding due to inflammation from the recent TURBT.

thanks for the responses.

David