I don't even know what to say..obvious that he did not get all the tumor or clean margins plus a perforation which must have been quite a serious one as most of them will heal on their own if it happens. The second opinion most definately needed quickly as he's now determined its in the muscle which means its invasive.
You're kind of in the middle of nowhereland as far as bladder cancer is concerned. The best is at The U of Oklahoma but i'm not sure if he specializes in bladder cancer or not and i'm sure going out of state is out of the question? Dr. Wong is the only one there with extensive experience in urology. I would call anyway and find out.
http://www.oumedicine.com/body.cfm?id=2329
And do have the B12 checked...it can cause symptoms of dementia as we age we lose our ability to absorb it and its a simple cure with a B l2 shot.
so sorry.......Pat

A 2nd opinion is certainly in order.

If she is in excellent health other than this, an ileal conduit surgery may be an option. Not sure what BCG is going to do if it is already muscle invasive.

Not sure i give much hope for her doctor. Perforating the bladder, then realizing he missed so much, etc. doesn't instill a lot of confidence.

See a urologist at a major cancer center. They have oncologists as part of the multi-disciplinary team.

Sorry to hear about how this played out so far.

Mike

Mike, Pat & all,
Thanks for your input. I haven't had time to look at this before now. I'm sorry about the confusion regarding the ovarian cyst & the bladder tumor. The CA-125 was negative. The surgeon said the cyst on the ovary was just that - no cancer there. But the bladder tumor was cancer & was larger than expected (at least 5 - 6 cm) coming off the anterior wall. He removed as much as possible during the TURBT & evidently perforated the bladder. He had to take her back into surgery & open her up to repair the perforation.
The pathology report stated: Urinary bladder - Papillary urothelial carcinoma, high grade. Transitional cell carcinoma, grade II/III. Extensive cautery artifact present. Invasive of the lamina propria identified. Muscularis propria present with no evidence of invasion in the examined sections. pT1.
Not sure what all of that indicates except we were told it wasn't in the muscle then. Her recovery has been slow. She was to start BCG treatments in mid October, but was still bleeding so had to wait. She had a procedure last week to find out where the bleeding was coming from & the doctor told us that the tumor had evidently grown & the pathological report says that it is now in the muscle. Doctor isn't giving her much hope. Basically he has said there isn't a cure & at her age he doen't think there are any options. Just wondering if anyone has had experience with someone her age having the bladder removed or partial removal. She was in great health prior to this - she doesn't take any medications. I just hate to see her not having any options & feeling as though there isn't any hope (medically that is!) I'm wondering if a second opinion isn't a good idea. Any recommendations for a great doc in OKC? Also should she see a urologist or an oncologist? As far as we know it doesn't seem to be outside of the bladder, but it is aggressive.

It was a good question Pat. That's why I shared the answer with you .

Mike

Sorry Mike..i did not have the advantage of a Private Message so i thought it was a good question.
Continue on
pat
P.S. Have her B12 checked...as low levels of that vitamin can produce dementia like symptoms and by age 90 noone has enough of that vitamin.

The CA-125 test is for ovarian cancer. My interpretation of the post was that came back positive for ovarian cancer and the doctor declared it aggressive.

The urolgist determined cancer from the cysto according to the private message you sent me. This is unusual as most of the time they wait for the actual pathology to make this determination. (responding to info from your private message). Some doctors will say this, but they really shouldn't until confirmed by tissue or cell examination.

At 90, the cognitive could be due to age, and when the stress of two cancers is added to that, it can certainly complicate matters. Advanced stages (metastasized) Bladder cancer can spread to the brain but it is way too early to make that determination. Once she has the TURB, they will know if it has gotten outside the bladder or if it has even gotten beyond the inner layer.

Let us know how the TURB goes and what they come back with. Please continue to post any questions you have. We will do our best to answer.

Mike