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2 years 5 months ago #51368 by Hogans
Thankyou Catherine for your response, to my understanding the Doctor plans to burn off any microscopic areas he sees first and then remove the tumour segment. He is doing this as a bladder sparing procedure because the tumour is located in the upper corner of my bladder which he says leaves enough room for my bladder to still function properly. He said he could not do that if it was located any where else near the opening or a location that would effect the bladder's fuction. That's all I have to go on, I will call the office tomorrow to find out about biopsies. I know I will have to be followed closely for recurrences. Hopefully the BCG treatment afterwards will prevent recurrences. If anyone else has had this situation, I would like to hear from them.

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2 years 5 months ago #51367 by CatherineH
Hello Hogans.... To reiterate what Cynthia said, welcome to the forum. I have read your post with interest because as others have thought, this doesn't seem to follow what we are used to as being the more common treatment path. The type of bc will dictate the best way to proceed.

I did have a partial cystectomy in 2010, but only after a 1.6 cm tumor was removed via a TURBT procedure and diagnosed/staged via a path report. There is a big difference in these two processes.

- A TURBT is done, as you stated, via an instrument inserted into the bladder to remove the tumor, and take other areas of tissue if needed for biopsy. It is a short out-patient procedure and you go home in a few hours.

- A partial cystectomy is major surgery where a complete section of the bladder is removed. The bladder is sutured and you will have to wear a catheter during the healing process, which for me was almost a month. Your uro has mentioned robotic surgery which may decrease the healing time for the abdominal incision, but the bladder still has to heal on its own. I opted for open surgery which involved an incision from just below the navel to just above the pubic bone.

Partial cystectomy is most often recommended for a bladder adenocarcinoma, which is one of the rare types of bc. If your path report hasn't come back, I'm not sure why they are making that recommendation so soon. The fact that they mentioned some other small areas needs to be investigated as well.

When you talk to them again, ask for a copy of your pathology report so you can fully understand your diagnosis, and the options they are offering. Also, a second opinion is always a good idea.

I had my initial TURBT locally but when the path report came back, my uro referred me to Vanderbilt because of the rarity of my diagnosis in his practice.

I am glad you are here in the forum looking for information. The more you know, the more you can take charge of your treatment plan.

Best wishes... Catherine
Forum Moderator Team

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 5 months ago #51363 by Hogans
I will call the Doctor's office tomorrow and ask if a biopsy has been done and what does it say. I remember the Doctor saying that I was fortunate that the tumour was located where it could be removed segmentally and then closed without effecting the other part of the bladder. Apparently they feel it should be totally removed that way instead of through the scope. Would this help prevent recurrence?

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2 years 6 months ago #51361 by Cynthia
Hogans sorry you have to be here but welcome to our community. The fact is that no one can tell you what you are dealing with by just looking at it. Stage and grade can only be determined by a pathologist looking at a cellular level. Many urologists have been doing this so long that they have a good idea of what they are looking at but the fact remains that unless they are superman and have microscopic vision they can't be 100% sure until the pathology comes back.
Getting a second opinion is always a good idea when you receive a cancer diognosis. I don't know what part of Alabama you are in but what you need is a doctor that does bladder cancer as thier main practice you will usually find these at University Hopsitals if you are in Northern Alabama Vanderbilt is excellent.
Good luck and we are here if you need us.

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 6 months ago #51359 by Hogans
I am located in Alabama. I heard the words Urothelia Papillary but I don't know what the biopsy says. My understanding is that the grade and stage will not be known until during surgery.

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2 years 6 months ago #51358 by Hogans
Thankyou for your response, I don't know what the biopsy is. It sounded like they would find out during surgery but they said the mass or tumour was located where it could be removed segmentally with clear margins also followed with a six week course of BCG.

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