My thoughts also. Not being able to clip the ticket so much.
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Yes they do have a big hurdle in clinical acceptance by the entrenched clinicians. However if they could just see past the end of their noses for a second that every test that is positive for bladder cancer will probably require further tests and cystoscopy and those that are negative will still need investigation for other causes. Either way they still get into the picture and with more patients clued up as to what is going on.
Furthermore as the population increases more doctors become qualified and replace the older established GPs.
With Pacific Edge being closely allied with Otago University I find it highly unlikely that recent medical graduates would be unaware of their own University's Research and Developments.
Great technology and now disruptive for the industry through a smart addition to their channel strategy. I'm certainly encouraged by this.
And as someone has said above, the docs still receive the results and can follow up with the patient as the doc desires (e.g. to book an appointment for further investigation/discussion). In fact, docs might see more patients because there are possibly a group of patients who have blood in their urine but are too stubborn to see a doc. Those patients can order a home test. The doc then gets the results (and therefor becomes aware of the fact that this patient has this symptom) and can follow up with the patient (regardless of what the results present) in case they want to suggest further investigation for cancer or other issues.
You only have to look at the popularity of things like WebMD.com in the States to see how much consumers are embracing the power of "personalised medicine".
The one who's got potentially the most to lose at this stage, reckons the urologists were making a fair call issuing that warning.
I was very sorely tempted to just take the CX Bladder test and hope everything would come out in the wash okay, (AKA sticking my head in the sand) but really this test compliments an ultrasound and cystoscopy not replaces it.
Fair enough to warn patients as lots of people absolutely hate invasive procedures and will do almost anything to avoid them, myself included.
Waitemata DHB's approach at present seems to be to recommend patients have the 3 day cytology test, (3 urine samples in a row to go under the microscope) then send people for a renal ultrasound and then a cystoscopy.
The Rat has reluctantly realised he needs to submit to all these procedures.
The CX bladder test may be better evidence than a cytology test but they don't seem to be using it...cost reasons ?
And after a couple of years lurking I have finally been flushed into the open.
I have bladder cancer. Haematuria got worse and worse over a week but as I had been eating beetroot I didn't worry until I peed black after the Japan Tonga game during the last world cup. Then I blocked up and had an A&E drama, admission, ultrasound scan and next day removal of a 2cm tumour which was attached to the bladder wall on a stalk which had not invaded the muscle layer. All good.
But my bladder wall grows them, and every 3 or 4 months I go to a clinic for a flexible cystoscopy. It takes about 15 mins. I lie on a gurney (sans pants) on a drawsheet. A nurse busies herself with a trolley, gloves, savlon etc, then takes my penis (respectfully) and squirts some anaesthetic jelly into my urethra, then puts a clip on my glans (gently) to stop it leaking out and gets on with preparing the cystoscopy gear.
The urologist comes in and unclips me and (very smoothly) slides the cystoscope up my urethra. We both watch progress on the big screen on the wall. Looks neat! We get to my prostate very quickly. From the inside it looks like a couple of rounded ridges on the bottom side of my urethra, with the urethra being squeezed into the "bumcrack" between them - all in glorious pink with the odd blood vessel darker. Going past the prostate has never been even slightly uncomfortable. Just past it is the sphincter at the bottom of my bladder. Folded and wrinkled. The urologist usually asks me to cough at this point but I don't - because the two or three times I have it has resulted in about half a second of minor discomfort. Now I just watch as he pokes the end of the cystoscope against the sphincter and it opens and then we are in my bladder. YAY!
He looks around at a variety of magnifications, and sometimes spots a little bright red spot (0.5-2mm). Zooming in on that, we see a pink coral polyp or small bunch of raw sausages (nothing to do with the Mad Butcher)attached to the bladder wall and waving around in the sea of urine.
So I get booked for a Trans Urethral Removal of Bladder Tumour (TURBT), and a few months later go to Hospital overnight for a GA and a procedure that takes about 15 min and leaves me with slight soreness on the end of my urethra for about 24 hrs. No big deal.
So I talked to the urologist. I gave him **** about patch protection (very brave while he's holing my member). He told me that his not using cxbladder is nothing to do with any $s that go to him. He is on salary. He says he doesn't use it because he carries the can for anything that goes wrong, that the Mk1 eyeball is still the gold standard for investigating bladder tumours, and that he sees no point in testing me with cxbladder and then using a cystoscope because he wants to be sure. He is also not convinced that the cost of using cxbladder stacks up well against the marginal cost of another cystoscopy (I am sure he is wrong - so is the nurse). He would have to be convinced that a protocol involving the use of cxbladder had become the gold stndard before he was prepared to use it. He sees its application in being in routine screening in groups at particular occupational risk (he mentioned people mining heavy metals)
I hope this helps
I would venture to suggest it may not belong before a few thousand people in the States who have a medical problem (or are concerned about a suspected medical problem) in this area will have googled such words and phrases as haematuria, blood in urine and bladder cancer and come across the DYI package offered by PEB, and even though it presumably won't be available to them (yet), they'll be asking their GP or urologist about it.
One thing they'll see is that it's got approvals from medical regulators in a country with high standards, so it's reputable, unlike a lot of stuff that can be ordered by email, and backed up by an informative website. And they'll also be able to tell their medical advisers it is actually available in the US. Could be quite a smart move for marketing in the US, not necessarily an admission of failure there. A certain amount depends on how well the metadata has been constructed into the PEB site and how well it gets picked up by Google, Yahoo etc.
It's clearly taken a while to get this project up and running with these approvals, so obviously well planned and thought through, I would say. And if PEB have kept this under wraps prior to the announcement, who knows what other surprises may be in the pipeline?