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A molecular clue for detecting bladder cancer

Yale Medicine Magazine, 2001 - Spring


Discovered three years ago, a gene called survivin holds promise as a diagnostic marker for bladder cancer, according to a study published by Professor of Pathology Dario C. Altieri, M.D., of the Yale Cancer Center, and several colleagues in the Jan. 16 issue of JAMA:The Journal of the American Medical Association. The sixth most common cancer in the United States, bladder cancer has a 5-year survival rate of 93 percent if it is discovered and treated early.

The current means of diagnosis, cystoscopy and biopsy, are accurate but also expensive and painful. What the Yale study found may lead to a noninvasive approach, examining cells that the body abundantly sloughs off every day into the urine. In an analysis of urine samples from 16 healthy volunteers and 60 volunteers with various types of cancer, the protein product of the survivin gene appeared in the samples from patients with new or recurring bladder cancer—but not in those from the healthy volunteers or volunteers with prostate, renal, cervical or vaginal cancer.

“The potential outlook for a test like this would be to improve the follow-up measures” for patients after treatment, says Altieri. Since bladder cancer all too often does recur, he adds, “We hope to see this urine-cell analysis develop into an alternative, safe, noninvasive and reliable approach at the first line of diagnosis.”

The lead author of the study was Shannon Smith, M.D., a urology fellow who died in March after a five-year struggle with brain cancer. “Her spirit was strong and inspiring and her commitment to this experimental work, even in the midst of the progressing disease, was admirable,” Altieri said.

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