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Cystoscopy

Cystoscopy

Cystoscopy (cystouresthroscopy) is a diagnostic procedure of viewing a person's urinary passage and the urinary bladder, collecting urine samples and examining the prostrate gland through an instrument. The cystoscope is as thin as a pencil and has a light at the tip. Many cystoscopes have extra tubes to guide other instruments for procedures to treat urinary problems. Through a cystoscope, the urologist can focus on the inner surfaces of the urinary tract. Some cystoscopes use optical fibers that carry an image from the tip of the instrument to a viewing piece at the other end.

Ridid cystoscope: This is a solid straight telescope that is used along with a high intensity light source and a separate channel to allow other instruments to be attached.
Flexible cystoscope: This is used particularly for diagnosis and follow-up of most bladder tumors. It is a fibre optic instrument that can bend easily and has manoeuvarable tip that makes it easy to pass along the curves of the urethra.

Cystoscopy is also done to evaluate problems that cannot be seen on x ray. Cystoscopy is used to further investigate the problems detected by ultrasound or intravenous pyelography. In women, cystoscopy helps to reveal uterine prolapse. A common and temporary side effect of this test is swelling in the urethra. A urinary catheter may be left in the patient's bladder to help drain the urine until the swelling in the urethra subsides.

Bladder Cancer

Bladder cancer is generally noticed in people over the age of 50. Quite often it is curable especially when it is found superficially on the surface of the bladder. At its more invasive and deeper stage, Bladder Cancer can be fatal. More instances of bladder cancer have been found in smokers, in particular those who have worked with PCB plastics or commercial dye industry.

This cancer occurs almost uniformly within the transitional cells of the bladder (the type of cell which lines the bladder wall). Transitional cell cancer is also found in the kidney and the ureter (the tube which connects the kidney to the bladder) although with much less frequency.

A urinalysis that shows an increased number of white blood cells without evidence of bacterial infection can lead to suspicion of bladder cancer. Urinalysis may also be remarkable for microscopic haematuria (blood in minute quantities). A cystoscopy allows the Urologist to look inside the bladder. This procedure is done under I.V. sedation or general anaesthesia. Cancer is detected with a biopsy or tissue sample. This is where a Pathologist can help in determining the extent of invasion of the cancer.

Chemotherapy agents are injected into the bladder through a catheter. These agents could include Adriamycin, BCG and other types of chemotherapy. If the bladder cancer is in an invasive stage, radical cystectomy may be required. This means a total surgical removal of the bladder. Radiation therapy which involves high doses of x-rays to localised body parts along with chemotherapy can be succesfully used to treat patients suffering from bladder cancer. When the bladder cancer has reached an advanced stage, it is generally incurable. A nutritious cancer diet is used to supplement the treatment.

PSA blood test

The Prostrate Specific Antigen (PSA) test enables the medical practitioner to detect prostrate cancer at an early stage. Prostrate Specific Antigen (PSA) is a protein produced in small amounts in the cells of the prostrate gland. A PSA blood test helps to determine whether stage of prostrate cancer is advanced enough to perform a biopsy of the prostrate gland or not. When the prostrate gland enlarges, PSA level in the blood tends to rise. This is indicative of cancer or benign non-cancerous conditions. PSA is called biological marker or tumor. As men age, both benign prostrate conditions and prostrate cancer become more frequent. The most common benign prostrate conditions are prostatitis which is inflammation of the prostrate, and benign prostatic hyperplastia which refers to the enlargement of the prostrate. When the PSA test is combined with rectal examination, 90% of prostrate cancers can be detected. In the U.S., the American Cancer Society recommends PSA blood test at least once a year to avoid the risk of prostrate cancer.

The PSA test has been called the 'male PAP test'. The normal range for a PSA blood test is between 0 - 4 ng/ml (nanograms per milliliter). A PSA level of 4 - 10 ng/ml is considered slightly elevated. Levels between 10 -20 ng/ml are considered moderately elevated. Anything about 20 ng/ml is considered highly elevated. Although the higher the PSA level, the higher the risk of cancer, one abnormal PSA test result does not necessarily mean it is cancer that is present, as various other factors may cause PSA levels to fluctuate. The PSA test is a radioimmunoassay. In a diagnostic laboratory, the patient's blood sample is exposed to the antibody against PSA. That moment the amount of antigen (PSA) can be measured. It should be borne in mind that a man who is undergoing hormone therapy for prostrate cancer may have a low PSA test reading during or immediately after the treatment. The low level may not be a true measurement of PSA in the patient's body. It is essential that such patients brief the doctor who may probably advise him to wait a few months after hormone treatment before having a PSA test done.

PSA test does not help a man with fast-growing tumors or aggressive cancer. It helps only in detection of small tumor and slow growing tumors which are unlikely to threaten a man's life. PSA test also cannot detect cancers spreading to the other parts of the body beforehand. There is a fear of false positives test results in PSA testing. Sometimes PSA level could be elevated but that does not necessarily mean cancer is present. A fear of false negative test result can also occur in PSA testing. That is the PSA test result will show negative even if prostrate cancer is actually present in the patient. PSA blood test is often followed by other diagnostic tests such as ultrasound, x rays and cystoscopy to determine the presence of cancer or any other problem in the prostrate.