Urine Test for Cancer
Urine test for cancer utilizes midstream urine sample to detect disease in body, which includes different types of infections. In this case, urinalysis is used to check if there is blood in the urine as an indication of infection or if certain types of drugs are present. The tests analyze urine by physical, microscopical and biochemical techniques. If a cancer diagnosis is being sought, the cells are collect from the urine by centrifugation (a process use to separate the cells from the liquid urine) and a special microscope is utilize to examine cells and plausible cancer activity they exhibit and this is refer to as urine cytology test.
(Image Credits – shutterstock.com)
For cancer detection, if the urinalysis tests reveal abnormal cells, additional tests are carry out to obtain more information in order to confirm that there has been the development of cancer. Urinalysis tests have been use as a convenient method of identifying bladder cancer at early stages but it is not solely use as a screening test; however, other techniques are use to confirm a positive urine test result.
When is it important to have urine cytology test?
For preliminary cancer screening purposes, your doctor may order a urine cytology exam if you have the following:
- Have a family medical history of bladder cancer and are consider high risk for the disease.
- If you have a medical condition that is showing symptoms of unusual blood in your urine, burning sensation while urinating, constant pain during urination and the urge to urinate persistently.
- The test can also detect a variety of bacterial and viral infections.
(Image Credits – shutterstock.com)
How is urine collected for cancer cytology tests?
- Urine is usually collected at your doctor’s office, clinic or a lab, but if it is 24-hour urine collection, you will be shown the procedure you will need for home collection.
- In general, it is advisable to collect first-morning urine.
- Midstream urine with no contamination from germs of the vagina (female) or penis (male) is required for testing.
- You may be provided with sterile, clean catch kit by your doctor containing a cleansing solution, sterile wipes, and collection container.
- You wash your hands first, open the kit, clean your genital area and then begin urinating.
- After the urine has flowed about half way, you collect midstream into the container, as you continue with the urine flow in the toilet until completion.
- Careful tighten the lid on the urine container and return urine sample to your doctor.
- Your urine sample will be sent to a lab within an hour for examination.
A urine sample can also be obtained during cystoscopy procedure (examination of the bladder with thin, tube- like equipment with a camera at the end).
How do I prepare for urine collection for cytology tests?
- Certain foods such as sugar beets, blackberries, or rhubarb can color urine and made it appear like it contains blood so avoid eating any of them prior to the test.
- Tell your doctor if you are on medication such as vitamin B, Pyridium (urinary system pills) and Dilantin an (anti-epileptic drug). These drugs will also color the urine.
- If your monthly cycle falls within the date you are ask to give a urine sample, let your doctor know, so you can be re-schedule to give your urine sample at a later date.
- Drink enough water prior to giving a urine sample so you can have enough urine volume give midstream urine.
What are the procedures for urine test for cancer?
Several tests are performe, as indicated in the picture below, from a urine sample provide by an individual in order to arrive at an indication that cancer might be developing or cancer is present:
Checking the appearance and concentration of urine-(1)
- Normal urine color can range from transparent (drinking excess water) pale or straw-like yellow to amber . A urine color chart is use to determine what is normal from abnormal.
- A pale to amber urine color is consider as normal.
- If you prepare well for the urine sample collection, the test will look for the abnormal appearance of blood in the urine which may cause it to turn pink, red or red-brown color.
- A straw-yellow urine color results from unusual bilirubin (a breakdown product of red blood cells or RBCs by the liver which is part of bile
- Observations are also made on clarity and concentration of urine.
- A normal urinalysis does not guarantee that there an absence of cancer of the urinary system; certain individuals will not show elevate substance or release abnormal cells in the urine early enough to be detect in a disease process.
- If the urine sample was collected accurately, avoiding interference of certain foods, medications, and dietary supplements, red-colored urine is an indication that blood is present and represents a disease state that has cause damage to an organ of the urinary system. Cancer of the bladder is an example.
- Cancer in the kidney, bladder, or ureter may shed cancer cells into the urine. This is referred to as renal transitional cell carcinoma (TCC), or renal urothelial carcinoma (UC). In fact, it is a malignant tumor which originated from epithelial cells lining the urinary tract. The tumor marker tests indicate can be use to detect their presence and levels to provide information of urinary system cancer.The tumor marker assays may occasionally yield false positive or false negative results so they cannot be solely relied on. Thus there is always the need for the tests to be confirm by other detection techniques.
Microscopy examination of urine-(2)
- This test is also known as urine cytology test. It involves viewing urine sample under the microscope for the presence of significant amount of different types of cells and in the case of pre-cancer or cancer cells, the test also looks at their characteristics.
- The appearances of red blood cells and white blood cells in the urine are due to kidney or bladder injury or inflammation. They can also be due to urinary tract infection (UTI), bladder cancer, lupus or inflammation of the vagina (in women) or the foreskin of the penis (men).
- Special microscopes are use to tell the presence of precancer and cancer cells and their abnormal activities.
- When urine is being examine under the microscope, tiny tube-shaped particles may be seen. These are called urinary casts. They may consist of proteins, fats, red blood cells,white blood cells or kidney cells. A number of casts provide information about healthy or abnormal kidney function.
- If crystals are found in the urine, they may result from the formation of kidney stones, certain types of medications in use or metabolic disorder.
- If bacteria or yeasts are found, it could be due to UTI.
Biochemistry tests for urine tumor markers
- Recently, innovative tests have been designe to find substances in the urine that might indicate early detection of bladder cancer. These are as follows:
- Urovysion Bladder cancer kit-utilizes fluorescence in situ hybridization (FISH) technique (a technique used to detect and locate the presence or demonstrate the absence of specific DNA sequences on chromosomes) of urine specimens to observe chromosome abnormalities associated with cancer cells of the bladder.
- NMP22 bladderCheck-nuclear matrix protein (NMP22) is a normal bladder protein whose levels are unusually high during the development of bladder cancer. The test utilizes an assay technique called ELISA to detect the elevated protein levels. It is a rapid assay method which lasts only 30 minutes with 4 drops of urine.
- ImmunoCyt urine test-This is a highly sensitive and reasonably specific test used in particular, for the detection of bladder cancer. In particular cells are separated from the urine and tested for mucin (glycoprotein produce by epithelial tissues) and carcinoembryonic antigen (CEA), which are frequently present in cancer cells. In general, the test utilizes ELISA technique to determine the presence of these two cancer marker proteins.
- BTA-Track test-This is a quantitative ELISA test that utilizes urine sample to determine the presence of bladder tumor-associated antigen (BTA) in the urine. In this case, a positive result is an indication that bladder cancer might be developing.
- Bence-Jones Protein (BJP) test-This is an abnormal protein present in the urine of approximately 50% of patients suffering from multiple myeloma (cancer of the immune cells). ELISA technique is utilized to detect this unusual protein in a urine sample.
What are the typical results for urine test for cancer?
(Image Credits – shutterstock.com)
All the three results, visual, microscopy and biochemistry, are interpret to arrive at what might be an indication of cancer.
- If the urine sample was collect accurately, avoiding interference of certain foods, medications, and dietary supplements, red-colored urine is an indication that blood is present and represents a disease state that has caused damage to an organ of the urinary system. For example, Cancer of the bladder.
- In general, yellow-brown or greenish-brown urine may be a sign of bilirubin leaking from the liver into the urine. It may also be due to obstruction of the bile duct (the tube that transports bile from the liver and gallbladder through the pancreas to the upper part of the small intestine (duodenum). This can give an indication of liver cancer or bile duct cancer.
- Blood test, together with different imaging tests can be use to diagnose blood cancers (leukemia, lymphoma, myeloma and myelodysplastic syndromes).
- In fact, cancer in the kidney, bladder, or ureter may shed cancer cells into the urine. This is referred to as renal transitional cell carcinoma (TCC), or renal urothelial carcinoma (UC). It is a malignant tumor which originated from epithelial cells lining the urinary tract. Tumor marker tests indicate can be use to detect their presence and levels to provide information of urinary system cancer.
What are the limitations of urinalysis?
- A normal urinalysis does not guarantee that there an absence of cancer of the urinary system. Certain individuals will not show elevate substance or release abnormal cells in urine early enough to detected in disease process.
- Certain individuals will release proteins into the urine at irregular intervals, such that they are lost in the sample collection.
- If the urine is very dilute, small quantities of tumor marker proteins may be undetectable.
- The tumor marker assays may occasionally yield false positive or false negative results so they cannot be solely rely on. Thus there is always the need for the tests to be confirm by other detection techniques.
- Eisenberger CF, Schoenberg M, Enger C, et al. Diagnosis of renal cancer by molecular urinalysis. JNCI J Natl Cancer Inst. 1999; 91:2028-2032. doi: 10.1093/jnci/91.23.2028
- Huber S, Schwentner C, Taeger D, et al. Nuclear matrix protein-22: a prospective evaluation in a population at risk for bladder cancer. BJU Int. 2012;110:699-708. doi: 10.1111/j.1464-410X.2011.10883.x. Epub 2012 Feb 7.
- Hautmann S1, Toma M, Lorenzo Gomez MF, et al. Immunocyt and the HA-HAase urine tests for the detection of bladder cancer: a side-by-side comparison. Eur Urol. 2004; 46:466-71.
- Mian C, Pycha A, Wiener H, et al. Immunocyt1: a new tool for detecting transitional cell cancer of the urinary tract. 1999; 161:1486–1489.
- Gutiérrez Baños JL1, del Henar Rebollo Rodrigo M, Antolín Juárez FM, et al. Usefulness of the BTA STAT Test for the diagnosis of bladder cancer. 2001; 57:685-9.