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Bladder Cancer - Follow-Up Surveillance

What types of follow-up procedures or tests did you have to detect recurrences of bladder cancer?

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What is surveillance for bladder cancer?

Patients diagnosed and treated with superficial bladder cancer need to be followed up regularly to detect recurrences and treat them effectively. The following is a typical follow-up protocol:

  • Cystoscopy and urine cytology every three months for two years, every six months for the next two to three years and annually thereafter


  • Imaging study (CT scan/intravenous urogram) of the kidneys and ureters once every year (especially for high-grade tumors/those associated with CIS)

Cystoscopy and cytology detects recurrence in the bladder itself while CT/IVU is used to detect a tumor in the kidneys and ureters. Patients with bladder cancer are more likely to get upper-tract tumors which arise from the inner lining of these organs and share a common origin with bladder tumors. The risk of upper-tract recurrence depends on the stage and grade of the initial disease and the response of the tumor to BCG. Individuals with recurrent high-grade bladder tumors can have up to a 20% risk of developing a tumor in the upper tracts and need to be followed closely in this regard.

Commercially available tumor markers which are used to test urine samples for evidence of bladder tumor recurrence are also being used in follow-up protocols. However, their exact role is undefined as of now and they are not considered an adequate substitute for cystoscopy and cytology. Some of these markers are NMP 22, BTA Stat, BTA Trak, and UroVysion.

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