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Atypical Squamous Cells in urine cytology

Posted by di341 @di341, Mar 28, 2023

Big hugs to those of you dealing with kidney and bladder issues!

I have Lynch Syndrome (which is a cancer genetic) and as a result, have extra precautionary tests as part of my annual physical, including a urine cytology. This year it came back with a finding of Atypical Squamous Cells present.

This can be the result of contamination but it's not in my case. Currently, we're looking for the cause. It is a mild presentation so I don't know what can be detected. Last week I had a total body MRI and this week I'm having my yearly ultrasound of the kidneys and bladder.

Does anyone have experience with this? Any advice or suggestions?

Thank you so much for your time.

Interested in more discussions like this? Go to the Kidney & Bladder Support Group.

vickyhay | @vickyhay | Apr 28 11:15am
In reply to @sepdvm "Hello @glinda47. My husband has battled bladder cancer for 5 years now with most of his..." + (show)
@sepdvm

Hello @glinda47. My husband has battled bladder cancer for 5 years now with most of his care at Mayo Clinic in MN. His local urologist missed his first tumor as did the radiologist reading the CT. Through this long journey he has not gone longer than 6 months for recheck cystoscopy, and/or CT. Even after a radical cystectomy with Neobladder surgery. Mayo urologists stay on top of the metastatic possibilities even without a Lynch background. I would recommend a second opinion from a top notch cancer or referral center. Are you near one at all? We travel OH to MN multiple times a year for our cancer care at Mayo.

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Within the last several years, advances in bladder cancer treatment have lead to the questioning of the need for a radical cystectomy. Using translational medicine and tumor genomics, often other treatments are just as proficient, and indeed, bladder sparring is now an option for many. When you point out "metastatic possibilities", a radical cystectomy may decrease this but so can other newer therapies. And thankfully so, for radical cystectomy is indeed life -altering.

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Sue, Volunteer Mentor | @sepdvm | Apr 29 8:25am
In reply to @vickyhay "Within the last several years, advances in bladder cancer treatment have lead to the questioning of..." + (show)
@vickyhay

Within the last several years, advances in bladder cancer treatment have lead to the questioning of the need for a radical cystectomy. Using translational medicine and tumor genomics, often other treatments are just as proficient, and indeed, bladder sparring is now an option for many. When you point out "metastatic possibilities", a radical cystectomy may decrease this but so can other newer therapies. And thankfully so, for radical cystectomy is indeed life -altering.

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Thanks for your input @vickyhay. Unfortunately the standard is still cystectomy and even Mayo Clinic does not discuss other options with much hope for cure. Cystectomy does offer the best option for total cure, and that is what my husband was looking for. I do hope that alternative treatments become more accepted, as the complications associated with neobladder surgery are many. I could not even get his urologist to perform genomic testing on his tumor prior to a trial on immunotherapy in 2020. You know surgeons.... "To cut is to cure".

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vickyhay | @vickyhay | Apr 29 12:10pm

I was not aware that Mayo was this conservative and out- of date. Recent research articles that have looked at bladder-sparing approaches , namely Trimodality therapy has confirmed that in selective patients the outcome is just as good.

Transl Androl Urol. 2023 May 31; 12(5): 802–808.
Published online 2023 May 26. doi: 10.21037/tau-23-124

“TMT is a well-tolerated and offers a curative alternative approach to RC for selected patients with localized MIBC. Appropriate patient selection and a multi-disciplinary approach is crucial in achieving good oncologic control with bladder-sparing therapy. Novel predictive biomarkers are anticipated for more precise patient selection and better oncological outcomes.”

And Tumor genomic profiling is at the forefront of this --

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