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Newly diagnosed, high grade invasive options

2 years 3 months ago #51827 by BB62
Thanks for the great input. I definitely will show these to my husband. He is about to start Chemo next Monday before anything else starts.

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2 years 3 months ago #51826 by sara.anne
I would have a serious talk with the urological surgeon about this. Partial cystectomy is not the usual treatment for this diagnosis. Please note that I am NOT saying it might not be the best option....heaven knows that we need new and better approaches in cases such as this!!! BUT I would want answers to a few questions:
1. How many of this type of surgeries in cases such as yours has he done and what is the success rate? (I would ask this question no matter what procedure is recommended!)
2. Is this part of a research or clinical trial protocol?
3. Are there any patients like you who have had this surgery that you might be able to talk to?
4. What would the approach be in case the bladder cancer shows up in other parts of the remaining bladder? Bladder cancer does have a nasty habit if coming back (or just showing up again) and your bladder has already shown that it is susceptible to it.
5. My urologist has told me that if it should come to a recommendation for radical cystectomy in my case (or any patient of his) he would INSIST that I seek a second opinion on his recommendation. If you have any questions about this, a second opinion would be the best option.

Wishing you all the best....

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator
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2 years 3 months ago #51825 by CatherineH
Hello... As Cynthia said, a partial hasn't traditionally been used for transitional cell carcinoma (TCC), but perhaps in your husband's case, the doctor is thinking that if he can remove the area where the T2 invasive tumor was found with clean margins, then with regular monitoring, he can take care of any future recurrences before they progress past the Ta or T1 stage.

It seems doctors are leaning more toward bladder preservation if possible, so that sounds like the approach Dr. Baracus is taking. The tumor site being in the dome is the area that allows the partial to be done. Just ensure you have a very candid discussion of how he would handle any future tumors because TCC does have a pretty high probability of recurrence.

As far as my own partial cystectomy, I cannot tell any difference now as far as bladder capacity than before the surgery. My tumor site was fairly small, so the resected wall was probably likewise.

Best of luck as the two of you move forward with his treatment. Please keep us posted as to how he is doing. I will be happy to answer any questions you may have about my own surgery experience.

Best wishes... Catherine
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TURBT 1/21/10 at age 55
Dx: T2aN0M0 Primary Bladder Adenocarcinoma
Partial Cystectomy 2/25/10
Vanderbilt Medical Center
Nashville, TN
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2 years 3 months ago #51824 by BB62
No he has High grade muscle invasive of the "normal kind" of BC. The tumor was on the dome of the bladder with no other location. That is why they are offering a partial. He also has a big bladder apparently.

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2 years 3 months ago #51823 by Cynthia
BB62, I finished (20 trips to chemo and 40 to radiation) radiation in December of 2004 and finish chemo in May or 2005. A biopsy in late summer showed CIS and I started BCG but had trouble with it as the bladder was so irritated by the radiation that I was nearly incontent and had bleeding following installation so it had to be put off time and again. In Febuary 2006 I was incontent and was bleeding so badly that they had to do an emergency biopsy and carterization. I had my RC on May 3rd 2006, about a year and a half after starting the bladder sparing protocol.
My orginal diognosis was T2 TCC but as they are offering your husband a partial I am assuming he has another type of BLC as they do not normally do a partial for TCC. We have a moderator who had a partial and has done at Vanderbuilt who has done very well and I will ask her to take a look at your post if she is available.

I hope this helps.

Cynthia Kinsella
T2 g3 CIS 8/04
Clinical Trial
Chemotherapy & Radiation 10/04-12/04
Chemotherapy 3/05-5/05
BCG 9/05-1-06
RC w/umbilical Indiana pouch 5/06
Left Nephrectomy 1/09
President American Bladder Cancer Society

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2 years 3 months ago #51820 by BB62
My husband has T2 and Dr. Boracas at Vanderbilt suggested a partial cysectomy and chemo. The local oncologist said in Europe the longevity is the same with chemo/radiation vs partial.
How long after your radiation did you have to get a RC?

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