A simple urine test may help doctors do more than detect bladder cancer. New research suggests it could also help monitor whether treatment is working and identify which treatment may be most effective for an individual patient.
The test looks for RNA released by tumor cells into the urine. In a study, the test accurately detected bladder cancer and provided information about the biology of the tumor that could help guide treatment decisions.
The findings are especially important because bladder cancer can return after treatment, making regular monitoring an important part of care.
Why a urine test could make a difference
Today, doctors commonly use cystoscopy to diagnose and monitor bladder cancer. During this procedure, a small camera is passed through the urethra into the bladder so a doctor can look for abnormal areas. While it’s an important tool, it’s also invasive. People with a history of high-risk, non-muscle-invasive bladder cancer may also need cystoscopies as often as every three months.
A urine test could provide a simpler, noninvasive way to look for signs of cancer between procedures or potentially reduce the need for some invasive testing if future studies confirm its value.
In the new study, the test correctly identified 95% of people with localized bladder cancer and correctly ruled out cancer in 90% of people who did not have the disease.
The test could help show whether treatment is working
Another potentially important use is monitoring cancer after treatment.
After surgery to remove a bladder tumor, some people receive BCG immunotherapy, which is placed directly into the bladder. BCG activates the immune system to attack cancer cells that may remain after surgery.
However, BCG doesn’t work for everyone.
The researchers found that people whose bladder cancer responded to BCG tended to have RNA in their urine showing signs of active T-cell and immune-system activity before treatment. People who didn’t respond were more likely to have RNA patterns associated with rapidly dividing tumor cells.
The test was also able to identify signs of cancer that remained after surgery and BCG treatment.
This could eventually give doctors another way to determine whether treatment is working without relying only on invasive procedures.
Could a urine test help choose between treatments?
Another interesting finding is that the RNA patterns may also help doctors predict which type of treatment is more likely to work. Using the RNA information, the researchers developed a biomarker that predicted whether a person’s tumor was more likely to respond to immunotherapy or chemotherapy.
What does this mean for people with bladder cancer?
The research points toward a future in which a urine sample could provide doctors with much more information about bladder cancer. It could make bladder cancer monitoring less invasive and, importantly, help move treatment decisions toward a more personalized approach.
However, this test isn’t routine bladder cancer care. The researchers plan to study it in larger clinical trials involving multiple medical centers to confirm how well it works and whether it can improve treatment decisions.
For now, the findings are an encouraging step toward using a simple urine sample to learn not only whether bladder cancer is present, but also what the cancer is doing and how it may respond to treatment.
Disclaimer: The information provided in this article is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Outcomes4Me is not acting as your caregiver, and any suggestions or guidance offered should not replace the advice of your healthcare provider or qualified medical professional. Always seek the guidance of your physician or other qualified health provider with any questions you may have regarding a medical condition.
