yes, we are definitely confused by these events! We wonder why the TURBT was not done at time of biopsies? Altho, in saying that, he did have a lot of bleeding from glomerations as soon as the scope went through to bladder. But even before surgery, that term was never used in any explanation. I guess we havent had to deal with serious medical issues before so you don`t really know about asking lots of questions etc & you just kind of go along with what the `experts` are saying! Maybe, because he booked in to have cyto & biopsy only, it has to be another session to have TURBT - being public & the next sheep is ready & waiting for his turn!! Who knows how the system works. I know we got a less than friendly reaction when we mentioned going to see someone else. Maybe they still plan to do BCG anyway after this `experiment`? I guess its all good work experience for a lot of people! Sorry, can`t help being a little cynical.
7 biopsy results were: 1 showed CIS, 2 were suspicious of. 1 showed atypia & chronic inflammation. 1 showed ` a few atypical cells were seen within the lamina propria & this is of uncertain significance, but early stroma invasion cannot be excluded with certainty.` 2 were clear.
Now, I am confused as to whether TURBT is a treatment or a way of diagnosing!? Interesting you say in the US, it is used when biopsies are taken as the uro we say privately for second opinion also said he would have done this at the time of cyto if he saw anything, & he is from South Africa. I wonder if I am understanding exactly what TURBT is? We believe it to be a treatment where small areas of abnormality within the bladder are cauterised & cleaned up etc & a checkup a year later. is this correct?
Thanks for your help Sara Anne.
I am somewhat confused...as you probably are!!! Didn't Greg have a TURBT already? Isn't this how the biopsy samples were obtained? Some times a TURBT
(translates to "transurethral biopsy of tumor) can be a treatment for very low grade tumors, since they are removed, but it is usually considered a diagnostic procedure. In the US, it is, however, considered appropriate to repeat the TURBT several weeks later and this has proven to give a much better diagnostic picture. The urologist has a better idea of where the problem areas are and can concentrate his biopsies there. It is very important that the biopsy samples are sufficient to show whether or not the cancer has spread into the underlying areas or muscle.
If, indeed, CIS (carcinoma in situ) is confirmed, and if the cancer has not penetrated into the underlying areas, I would be very surprised if BCG is not recommended, since it has shown to be curative in about 70% of CIS.
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Hello again - well, after being under the impression from the hospital specialist that Gregs treatment would involve BCG, then removal if that didnt work, we saw our own GP (General Practitioner) this morning - unrelated to thsi diagnosis. He had received a letter from the hospital saying what had been decided regarding Gregs treatnent. They want to try TURBT. This is what the uro whom we saw last week, as a private patient, would have done while doing cytoscopy if he saw any tumours or CIS. We wonder why Greg has never had this treatment after 3 cytos! Also, in the letter to the GP, it said, `cyto showed multiple areas of erythema & the biopsies have come back showing a combination of T1 urothelial carcinoma, with carcinoma insitu also.` We are wondering why the change in treatment plan & TURBT sounds a lot more `user friendly`, for want of a better phrase, than BCG! Can it be successful on this type of BC?Also, it was just by chance that we learned of that letter today because `they` are not good at sending the patient all teh letters, results etc. They make all the decisions & then inform you when it suits! Greg is not due to see the hospital agin till Dec 3 so would have had 6 weeks of thinking there is a good chance he will lose his bladder when they had already decided they could try this other thing!
makes him think he shoudl forget the public system & spend thousands more on a private uro.