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PA doctors

8 years 11 months ago #29339 by mmc
I agree with you Pat.

Pam should get a 2nd opinion from one of the docs that Pat mentioned and have that doc redo the pathology analysis.

Mike

Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results....distant mets
2/2014 ct result...spread to liver, kidneys, and lymph...

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8 years 11 months ago #29338 by Patricia
Yeah...this is confusing. This pathologists reading does not show invasive. I would still recommend to deaf ears that another opinion is sought simply because the uro put RC on the table for consideration...or another pathologist look at the slides. Really ought to have stage and grade. Looks like it might be T1 Grade 2 with lamina propria dysplasia??
Pat

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8 years 11 months ago #29337 by Webs
Mike,

I don't really understand what is going on either. I hope she registers soon. It is hard to do things third person.

I really do not understand why RC was brought up, but I am also not great with the technical side of the disease.

Webs

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8 years 11 months ago #29335 by mmc
Webs,

What did this person's doctor say?

From the report it looks like it is NOT T2.
Says they got muscle and nothing there.
Also says "no carcinoma".

Unless this is a re-TURBT from high grade recurrence, I'm not sure why RC is on the table. Unless, the original TURBT pathology showed muscle invasion and they got it all the first time.... In that case, RC is probably the answer.

Mike

Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results....distant mets
2/2014 ct result...spread to liver, kidneys, and lymph...

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8 years 11 months ago #29330 by Webs
I have heard from Pam again and she wrote back with the info on the path report. So here it is. I have never been good at deciphering these.

Webs

Final diagnosis:
Part 1 : urinary bladder , tumor base, cystoscopic biopsy { oss s09-3305,1A 10/26/09 nason hospital
A.Single fragmant of necroinflammatory debris.
B. No evidence of carcinoma.
Part 2 : urinary bladde , base of previous tumor , transurethral resection {oss s09-335,2A , 10/26/09 nason hospital
A. One of multiple urothelial mucsoa fragments with foal urothelial dysplasia{ see comment}
B.Focal mild scute inflammation of lamina propria.
C.No evidence of invasive urthelial carcinoma.
D. detrusor muscle is present and is negative for carcinoma.
AFL/AFL
Comment:
Part 2 : multiple tissue fragments are examined in part 2 . One fragment is lined by urothelial mucosa with features of atypia , icluding nucleomegaly and numerous mitotic fiures. the atypia seen is below the level of what is required for carcinoma in-situ,and is therfore best clasified as dysplasia. However on evidence of carcinoma is seen.

I do not see stage or garde spelled out in this one as in first one . Thanks ,

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9 years 4 days ago #29243 by Patricia
WEbs..I don't know much more that i can do but give my time and energy to seek out the top bladder cancer specialists in the Pittsburgh area. Pam obviously did not think much of my referrals.
If its T2 its invasive so good luck with BCG.

What else can anyone else say if this man won't move his butt out of his house and seek a professionl opinion from a top specialist? Sticking your head in the sand really doesn't work with bladder cancer.

Honestly its posts like this that just make me want to quit being an advocate. I treasure every moment i can spend with my family and i grieve the loss of my husband still every day and i have another battle coming up with another primary and maybe this time i won't be so lucky but i'm not throwing any dice. I'm going to a top specialist and hopefully i will still have some time left.
Pat

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