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Pathology Came back...

2 years 8 months ago - 2 years 8 months ago #50858 by Alan
Don't focus on one study, pro or con. They are just stats. If we have bladder cancer it is 100% and if we don't that is 100% we don't-that is stats. I don't mean to be dismissive on that comment. IF there is a generalization I would guess 70% are helped by BCG. The VAST majority of us survive bladder cancer, something like 5/6 vs 1/6 that don't. Your diagnosis is very similar to mine and I am cancer free 8 years later. Due to very early DX, skill of a very good surgeon and BCG. The immunotherapy is doable. How many people do you know that have had to go through the rigors of chemo? Sure this is not a lot of fun but very doable. Just like the scopes that were every 3 months, then 6 now every year. Uncomfortable but not painful, a nuisance. If that is the worst going forward, I'll take it.

DX 5/6/2008 TAG3 papillary tumor .5 CM in size. 2 TURBS followed by 6 instillations of BCG weekly with a second round of 6 after a 6 week wait.
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2 years 8 months ago #50853 by sara.anne
BCG is the treatment of choice for high-grade bladder cancer. There is a TON of information in this forum on BCG. For a start, go to the top of the "Non-invasive" thread of this Forum. BCG is very do-able; it does have some side effects which vary with the patient, but is much easier to tolerate than traditional chemotherapy. Hundreds of us on the Forum have had it and are still here, cancer-free.

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 8 months ago #50852 by jroza1
This is the recommendation from my doctor...

There is another therapy we should consider. This is called immunotherapy (immune system related therapy). This is done by placing a small catheter into the bladder and putting in a small amount of liquid containing the vaccine for tuberculosis. This is done once a week for 6 weeks starting 3 weeks after the surgery. It is then repeated once a week for 3 weeks at 3 months, 6 months, 12 months, and 18 months after surgery for a total of 27 treatments.

Here is a guideline analysis of this treatment:

However, in this high-risk group, maintenance BCG is superior to mitomycin C with or without maintenance. In our single-arm meta-analysis of randomized controlled trials of high-risk patients, the estimated five-year recurrence rate was 34% in patients receiving TURBT and BCG maintenance and 62% with mitomycin C maintenance. The meta-analysis of all risk groups found that, compared with TURBT and mitomycin C maintenance, TURBT and BCG maintenance therapy reduced recurrence by 17% (95% CI: 7, 26). In addition, there are limited data suggesting a trend to preventing progression with maintenance BCG. The progression in one study of 380 patients was reduced by 5% (95% CI: -1, 11) with TURBT plus BCG maintenance when compared with TURBT plus mitomycin C maintenance.84 Although maintenance therapy reduces recurrence and may reduce progression, the side effects and discomfort of the treatment and possibly the costs of the treatment may outweigh the benefits for some patients. Thus, discussion of the tradeoffs and consideration of patient preferences is important before beginning or continuing maintenance therapy.

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2 years 8 months ago #50849 by jroza1
Everything about this has had a bad omen!
"Dr., What's the negative of the surgery?"
"Slimmest of chances you might need a catheter...but outside chance - really low risk."

...I awake from surgery with a burning pain
"Awww WTF is that?"
nurse, "Doctor said it's best if you have a catheter for a few days..."

Yah, I have been looking at the good news and bad of this for the last month. Thank gawd we caught it early, thank gawd it was operable, thank gawd no chemo,... not at risk for losing my bladder, just means every 3 months a scope and it looks like 6 weeks of pain and discomfort.

So... What's BCG like?

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2 years 8 months ago #50848 by sara.anne
You have probably figured this out already...
The "bad" news....high grade, so you are getting BCG
The "good" news.....the tumor has not invaded other layers AND
muscle was present in the sample so they can be pretty sure it had
not invaded the muscle.

AND you are on the road to recovery!!!

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 8 months ago #50847 by jroza1
Thoughts? My Doctor has been light on details. My next scope is in 3 months.

Pathology Report
FINAL PATHOLOGIC DIAGNOSIS
BLADDER TUMOR, TURBT:
- PAPILLARY UROTHELIAL CARCINOMA, HIGH-GRADE
- NEGATIVE FOR LAMINA PROPRIA INVASION
- MUSCULARIS PROPRIA IS PRESENT, NEGATIVE FOR TUMOR INVASION

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