Will try to answer at least some of your questions. First, "RPG" stands for a "retrograde pyelogram," which is an xray technigue which uses a dye to allow the urologist to check the flow of urine from the kidneys to see if anything is obstructing it. He will be checking to see if the kidney stone is causing any problems in this area.
The TURB (transurethral resection of the bladder) is both a way to remove as much of the suspected tumor as possible and a way to obtain tissue to send to the pathologist for a complete diagnosis. It is done as an outpatient but under general anesthesia. After the TURB the urologist may have a pretty good idea of what you might be facing, but the complete picture will not be available until he and you get the pathologist's report....and this can take up to a week or so. Immediately after the TURB the urologist will probably wash the bladder with mitomycin, which is a chemo agent. How you will be feeling after the TURB depends on a lot of things, including how much tissue the urologist needs to "scrape" or cut out, how deeply he needs to go, and the location of the samples he takes. In my case, I just woke up and went home and resumed normal activities. Sometimes, and more often with males, the patient may go home with a catheter which is taken out in a day or so. You probably won't feel like riding a horse for a day or so!!
As for what the future holds, you will know better once the path report is back. If the tumor is small and low grade, treatment may only consist of frequent visits to the urologist for cystoscopy...about every three months...because bladder cancer has a bad habit of returning, requiring constant vigilance. If the tumor is high grade (which means that it is rapidly dividing and has the potential to spread) your urologist may recommend BCG treatments, which are very do-able, but may cramp your style for a couple of days at a time. Just remember that bladder cancer, if found early, is very treatable.
After the TURB and the path report, which you should get a copy of, you and the urologist can have a thorough discussion of what the options are as well as what your future might hold. At that point, I would think, you will need to decide whether to pursue a second opinion,. I suspect that other members will chime in on this subject.
A couple of things to remember...yes, smoking is one (just one) possible cause of bladder cancer, but many people who have never smoked nor been exposed to any of the other suspected causes also show up with bladder cancer. There is no point in worrying about that now, since the horse is out of the gate, so to speak. And, as I mentioned above, early bladder cancer is very treatable. Even if it is not caught early, it is possible to lead a very full and satisfying life.
Wishing you all the best, and please keep us informed. I know that you must have all sorts of questions popping up so feel free to ask and someone here will be able to help.
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
The following user(s) said Thank You: dani, dtat60
Hi Everyone! My name is David, I am a 66 year old male living in rural Central Texas.
I am retired and walk 5-8 miles a day and have for the last 13 years. I have noticed dark urine several times in the last few years and always thought it was from dehydration, especially during the summer. I would drink a lot of water and it would clear up so never thought that much about it. This July suddenly I noticed blood in my urine - not dark this time but distinctly reddish tint. I drank water but this time it didn't clear up for several days and then seemed to go away. I ignored it. Then in August it came back and didn't seem to go away.
I went to my GP and he said that he suspected a kidney stone. I was having some discomfort (not much) under my right rib area. He sent me for a x-ray (KUB) and it showed a 10mm non-obstructing kidney stone in my right kidney and recommended that I see a Urologist. The soonest I could get an appointment was first week of September. The Urologist took another x-ray and confirmed the stone but recommended a CT Scan and Cystoscopy on 9/26. I watched as he did the scope and he pointed out the tumor in my bladder. It confirmed my fears - I had of goggled Hematuria, etc.
I am scheduled for Cystoscopy RPG's, TURBT on Oct. 13th. The Urologist said he would "scrape" off the tumor and then inject a chemical into my bladder to discourage a re-occurrence.
I am in shock - I did smoke but stopped when I was 45....I guess too late. I'm having a bit of a time coming to grips with my situation.
A few questions -
I assume that I won't know anything until after the TURBT? What is RPG's?
I am concerned whether I will be able to maintain my lifestyle in the country. I have cattle and my place requires a bit of maintenance.
I live 1 hr. from Austin, 1.5 hr. from San Antonio, and 3 hr. from Houston. My Urologist is in Austin. Looking at the "Treatment Center Finder" it mentions MD Anderson in Houston and UT Health Science Center in San Antonio. I was wondering if it would be better to maybe go to UT-San Antonio for treatment (it would be a bit longer drive than Austin). Not sure if going to Houston would be possible. But at this late date I will probably have the surgery in Austin on the 13th.
Any thoughts on my situation? Thanks for listening.