METHODS AND COMPOSITIONS FOR RISK STRATIFICATION AND MANAGEMENT OF BLADDER CANCER
Here, we propose an alternative surveillance strategy at follow-up visits of bladder cancer
patients, namely the use of urine D-dimer (assayed by ELISA or LFA), in place of currently used methodologies. In this novel management algorithm, if the urine test is positive for D-dimer, only then does the patient need to have a biopsy done (via a cystoscopy), to confirm the diagnosis. Otherwise, the patient will simply be reviewed at the subsequent follow-up visit. This will save the majority of patients from unnecessary invasive/expensive procedures (with sub-par diagnostic profiles), leading to overall savings (to the patient and overall healthcare) and also reduce the incidence of cystoscopy-related side-effects.
Moreover, we propose that point-of-care lateral flow test strips (LFT) for urine d-dimer can be used by the patient to self-test the urine for bladder cancer recurrence from the comfort of his/her home every month (or even every 2 weeks). This algorithm (“home-based surveillance for bladder cancer recurrence) would have the added advantage of detecting bladder cancer recurrence earlier than it is currently being detected, potentially leading to decreased patient morbidity and mortality.