Husband newly diagnosed

14 years 4 days ago - 14 years 4 days ago #31088 by nancikay
Replied by nancikay on topic Husband newly diagnosed
Thanks Pat.

The specimens for tumor A and B are actually the same tumor. The first (A) is the top part of the tumor, and the second (the B part) was the stalk and into the muscle.

I've looked up the info on UCSF and it appears they are in our insurance so that's awesome. I'm going to call them tomorrow. I read the CV's of both doctors to my husband and he said Dr. Meng sounds more up his alley. Both docs appear to have awesome educations! Do you think one is better than the other? It's so hard to choose. I would hope that if a doctor was treating you and then thought another doc in the same specialty could do a better job with something, they'd refer you, but I doubt it works that way.

So I guess we take the slides with us? Not sure.

On another note, I took my husband back to the doc today, he was having increasing symptoms pointing to a UTI. Although the dipstick in the office did not show infection, they gave him two shots, a prescription for Cipro, and are sending the urine off for C&S. They also gave him some ProSed DS samples and a prescription. He was really, really uncomfortable. They also did an ultrasound to see if he was retaining and he's NOT which makes me happy because prior to the TURB he was.

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14 years 4 days ago #31084 by Patricia
Replied by Patricia on topic Husband newly diagnosed
Nanci..it looks like the uro did not get enough of a specimen for tumor A...as the pathologist did mention the detrusor muscle in the other samples.
It all appears to be high grade though they did not specify grade and stage, but are suspicious of invasion.
You definately need to set up the second opinion NOW...I have a feeling they will take one look at the slides and want to do a second TURB. And i would go to UCSF..they have the best multidisciplinary team and great pathologists.
You don't want to mess around with this for any length of time.
Pat

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14 years 5 days ago #31055 by nancikay
Replied by nancikay on topic Husband newly diagnosed
Ok, I'll type it in here. I've already done a bit of a search on the internet and sort of think I kind of know a little tiny bit but......it is so confusing.

There were four specimens labeled A B C and D.

Microscopic Diagnosis:
A. Urinary Bladder, right posterior wall tumor, cystoscopic biopsy:
1. Superficial fragments of high-grade papillary urothelial carcinoma
2. No definite lamina propria invasion identified.
3. No muscularis propria (detrusor muscle) identified within biopsy material.

B. Urinary bladder, right posterior wall base of tumor, cystoscopic biopsy:
1. High-grade papillary urothelial carcinoma, focally suspicious for invasion into lamina propria, see comment.
2. Muscularis propria (detrusor muscle) present, uninvolved by tumor

C. Urinary bladder, right lateral wall, cystoscopic biopsy:
1. High-grade papillary urothelial carcinoma
2. No invasion into lamina propria identified.
3. Muscularis propria (detrusor muscle) present in biopsy,uninvolved by tumor.
4. Chronic cystitis.

D. Urinary bladder, posterior wall, cystoscopic biopsy:
1. High-Grade papillary urothelial carcinoma
2. No invasion into lamina propria identified.
3. Muscularis propria (detrusor muscle) present in biopsy, uninvolved by tumor
4. Chronic cystitis

Comment: Cellular nests of neoplastic urothelial cells are seen at the base of the tumor and, in some foci, appear to be below the basement membrane, and, as such, are suspicious for invasion. Part B of this case was reviewed with Lorinda A. Soma M.D. who agrees with the interpretation and diagnosis.

Diagnostician: Kristen N. Vandewalker M.D.

So thats what we have. any and all comments welcome.

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14 years 5 days ago #31053 by mmc
Replied by mmc on topic Husband newly diagnosed
You could retype the info from the pathology here and we can help translate.

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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14 years 5 days ago #31052 by nancikay
Replied by nancikay on topic Husband newly diagnosed
Mike, thank you so much! I will definitely take a look!

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14 years 5 days ago #31051 by nancikay
Replied by nancikay on topic Husband newly diagnosed
Pat, thanks for those names. We got the pathology report, and of course to me its all gibberish. Where should I post that so someone can help me decipher it?

My husband did return to school today. He has a pretty hectic schedule, he works at his own business and then went back to school a year ago to get his A&P certification, so he goes to school from 4-10 5 days a week. He hasn't really been back to work yet, but work is super slow so its not a big deal. I'm glad he was feeling up to trying school though.

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