POSITIVE FISH TEST

MY HUSBAND HAD HIS CYSTO 2 WEEKS AGO. ALL WAS CLEAR, THEN YESTERDAY HIS DR CALLED AND SAID THE FISH TEST WAS POSITVIE AND WANTS HIM BACK IN THREE MONTHS. THIS IS THE FIRST FISH TEST THAT HE HAS EVER HAD COME BACK POSITIVE. EVEN WHEN HE HAD AN TUMOR THAT WAS CANCER THE FISH WAS NEGATIVE. I AM NOT QUITE SURE WHAT TO THINK OF THIS. HAS ANYONE ELSE HAD THIS HAPPEN. I WOULD APPRECIATE YOUR COMMENTS.
THANKS,
KIM

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FISH tests do have occasional false positives. So, followup is essential. Keep your appts. That is why all these tests are necessary. The cysto in 3 months will assist with determining if this FISH test is correct or not. You might ask for an IVP to look at kidney/ureter health too.
Karego

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Hoping jj will chime in here as he knows alot about Fish tests.

My guess is that yes, there are some cancer cells floating around in his bladder even though the urologist didn't see anything at the cysto. And from what I remember, FISH tests aren't always accurate as you see from the previous FISH he had.

3 month cysto is the normal routine. He may have cells there but nothing the uro can remove until they develope into the tumour (s).
Can you give us a background on his diagnosis. Type of cancer and grade. How many TURB ( surgery to remove tumours)

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I Kim
I had a FISH test that came back negative, but during Cysto there were 3 tumors all TA low grade. FISH tests do not have a great record on picking up low grade cancer is what my Uro explained to me.
I would recommend you ask for another FISH test, as there can be false positives with the test. Why wait 3 months for another Cysto. I am sure this will play on your mind, so I would want an answer myself asap.
I wish you all the best,
Jack

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I TOO WAS UNDER THE IMPRESSION THAT FISH WERE BETTER FOR HIGH GRADE CANCER AS WELL. AND ALL OF HIS TUMORS HAVE BEEN LOW GRADE. SO OF COURSE NOW I AM THINKING DOES THIS POSITIVE FISH MEAN THAT HE COULD HAVE A HIGHER GRADE OF CANCER?

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MY HUSBAND HAS HAD BLADDER CANCER ON AND OFF FOR THE PAST 3 YEARS. HE HAS HAD IT COME BACK 3 TIMES. ALL HAVE BEEN LOW GRADE NON-INVASIVE. LAST TUMOR WAS 1 YEAR AGO.

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Thanks for the info Kim. Sounds like he is normal in his recurrence for the type of BC he has.

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Meant to add, has he had any BCG treatments yet?

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HE HAS HAD 12 BCG TREATMENTS ALL TOGETHER.

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2 rounds of 6 I would assume. Did he get some all clears after his treatments?

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ACTUALLY ONE ROUND OF 6 THEN 2 ROUNDS OF 3. AFTER THE FIRST ROUND OF 3 HE HAD A RECURRANCE ONE MONTH LATER. IN 6 MONTHS THEY DID ANOTHER ROUND OF 3 AND ALL WAS GOOD. MY HUSBAND HAS STARTED SEEING A NEW UROLOGIST THIS MONTH AT CLEVELAND CLINIC. HE HAD SAID WHEN HE DOES DO THE BCG HE WAS GOING TO ADD AN ADDITIONAL DRUG. I BELIEVE IT WAS INTERFERON.

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There are other tests they can do to check for bladder cancer besides FISH. Cytology and nmp 22 also test for bladder cancer. If he is still getting tumors with the BCG, Valstar is a drug that is used instead of BCG sometimes.

Lynda

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Kay, it would not hurt a thing to get a second opinion on the bladder pathologies as well as the treatment options you face. Hopefully this could be done through one of the cancer centers.

NancyN

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I believe that some urologists think that a positive FISH for bladder cancer in the absence of any other evidence of disease, represents the earliest possible evidence that there is a cancer. However, all tests, FISH included, have both false positive and false negative results. FISH is an incredibly sensitive test which usually comes with a loss of specificy (that is more false negatives). FISH is unusual in that it also has quite good specificity, particularly when combined with urine cytology. For me the bottom line is that FISH is an adjunctive test that when positive tips the scales in favor of bladder ca or CIS. It should alert you to the higher chance that you might have cancer, but does not mean that we through out all other tests and results and treat this as a cancer. I personally would require histologic proof of cancer, before embarking on any treatment. With a prior history of bc, I would certainly proceed with caution and require close follow up.

JJ

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Thanks I really appreciate all the information. The Dr's office is suppose to call tomorrow to set up his next cysto, so I will ask them a couple more questions.

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My May 3, 2010 FISH came back positive. In a cysto the same day, the uro saw some suspicious areas. A week later I has a same day TURBP. Yesterday the uro said the pathology report was negative - and scheduled me for a three month followup cysto. He also said BCG treatments may be the cause of the positive FISH (I have 14 BCGs since Jan. '09 : 6-1-6-1)

Ron

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