Scientists have made a big leap in how we can keep an eye on bladder cancer in people who are at high risk of the disease coming back.
They found that a simple urine test could mean a lot fewer uncomfortable doctor’s visits for these patients.
Normally, to check if someone’s bladder cancer has come back, doctors use a procedure called a cystoscopy. This involves using a thin tube with a camera to look inside the bladder through the urethra.
Although it’s a common way to check for cancer, it’s not very pleasant. It can cause infections, bleeding, and discomfort.
Recently, researchers in Denmark did a study for two years and shared their findings in April 2024. They discovered that using a special urine test could do just as good of a job at catching cancer early without needing so many cystoscopies.
This urine test looks for certain signs of cancer in the patient’s urine by checking for specific genetic markers.
In Denmark, people who have had bladder cancer and are at high risk of it returning must usually get cystoscopies every four months for two years to make sure the cancer hasn’t come back. In the UK, it’s even more frequent.
This is because there’s a high chance, about 60–70%, that the most aggressive bladder cancers will return within five years after treatment.
The researchers wanted to see if they could reduce these frequent checks with the urine test. They worked with 313 patients, splitting them into two groups.
One group got the standard cystoscopy three times a year, while the other group only had it once a year. For the other two checks, they used the new urine test.
What’s great about this study is that it’s the first of its kind to test the urine test in such a rigorous way. Before this, most studies just watched how well the urine test did without directly comparing it to the usual cystoscopy method.
The team was led by Thomas Dreyer, who is studying for his Ph.D. He mentioned that previous studies already showed the urine test could be promising.
The big question was whether this test would make patients need more cystoscopies because of false alarms. Fortunately, their study found that this wasn’t a problem. In fact, they saw that those who mostly had the urine test ended up needing fewer cystoscopies.
The urine test they used was called the Xpert Bladder Cancer Monitor test. It checks for cancer by looking for specific genetic markers in the urine. If the test suggested that the cancer might be coming back, the patient would then go in for a cystoscopy to double-check.
After two years, they found that those using the urine test needed significantly fewer cystoscopies.
Also, in some cases where the urine test indicated cancer but the cystoscopy didn’t see anything, the cancer would indeed be found later on. This suggests that the urine test might even catch cancer signs earlier than the cystoscopy.
Thomas Dreyer pointed out that many patients really don’t like having to undergo cystoscopies, but they do it to ensure they’re cancer-free. If they could choose, most would prefer just giving a urine sample over the discomfort of a cystoscopy, as long as it’s just as reliable.
Joost Boormans, a Professor of Urology, emphasized the need for alternatives to cystoscopies, especially since bladder cancer mostly affects older people. With an aging population, finding simpler ways to monitor for cancer is crucial to not overburden healthcare systems.
This new method, pending final results expected later in the year, could change how doctors follow up with bladder cancer patients. It could make check-ups less invasive and more comfortable, all while keeping an eye out for any signs of the cancer returning.
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