Barnstable County Report

County Takes Steps To Utilize New Test For Bladder Cancer

By George Heufelder, MS, RS, Director,
Barnstable County Department of Health & Environment
Bladder cancer is among the five most common cancers reported in the United States. Early detection results in a 94 percent five-year survival rate. And now we have a new tool for making even earlier detection possible.

It’s a simple, inexpensive, non-invasive test using only a few drops of urine and we’re taking steps in Barnstable County to make it available to some of the Cape’s most vulnerable employees, our firefighters.

The urologist’s most common tool for diagnosing bladder cancer is cystoscopy. Even polite descriptions of this procedure are less than pleasant. By any description, this test is considered “invasive” and useful only if symptoms are visible.

Now, to catch problems even earlier, researchers have identified a protein that is more abundant within cancerous cells and is excreted with the urine. This protein marker—NMP22 (nuclear matrix protein number 22)—appears at elevated levels in the urine of individuals having bladder cancer, even at very early stages. This is important, because once the tumors become more advanced the survival rate drops steadily from 50 to 10 percent.

The new test instrument (called BladderChek®) is about half the size of a credit card and directly measures the level of the protein marker in the urine without any invasive procedure. It is easily administered in a doctor’s office and the results are available in 30 minutes. The results are not hindered by the presence of blood in the urine.

Recent research suggests that firefighters may be at increased risk of bladder cancer, presumably due to their exposure to smoke and hazardous chemicals. Since early detection and intervention is so important, the Barnstable County Department of Health and Environment, in cooperation with our municipal fire departments, has instituted screening clinics using this newer technology.

Adding another simple test to detect blood in the urine (a signal of possible other problems in the bladder or urinary tract), many medical issues can be detected early. This allows earlier interventions, with the eventual avoidance of costly medical procedures…not to mention the saving of lives.

The cost-per-cancer-detected of BladderChek® is much cheaper than tools used to screen for other types of cancer, such as mammography. And there’s another financial consideration. Nationally, bladder cancer has the highest cost per patient of the major cancers from diagnosis to death. This year alone, it’s estimated that treating bladder cancer will directly cost Americans $4 billion.

If you are in a high risk group (commonly exposed to smoke and hazardous chemicals), you might ask your doctor/urologist whether this test is right for you. Early detection means early intervention and higher likelihood of survival. The costs are less than $30 per test if done in a screening clinic setting, 30 minutes of time and four drops of urine.

By anyone’s standard, well worth the effort. And, perhaps, no cystoscopy.