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Second Opinion

2 years 1 month ago #53050 by Mistersac
I had my first cystoscopy/ biopsy post my initial 6 BCG treatments today. My Uro said that he didn't see anything suspicious, but I guess the results of the biopsy will tell the story. With CIS I guess it pays to be ultra vigilant, for it is more aggressive, but not coming home with a catheter was a relief.

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2 years 1 month ago - 2 years 1 month ago #53036 by Alan
Mistersac!

Another golfer! I play a lot also. I usually play the nexy day on a scope. My TURB's were so long ago my Elmer's disease (a little levity on my diminishing memory) don't let me recall how long I waited. I want to say 3-4 days BUT, that also depends on how extensive the TURB was. Mine was all of 20-25 minutes & minor. The bigger problem was the BCG where for 24-48 hours after I had to know where the nearest restroom or bush was!

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 1 month ago #53033 by Jack R
The bladder has to heal following a TURBT or biopsy. About two weeks later it is best if the the scabs come off naturally instead of being forced off by muscle activity.. Two to three weeks of protecting the bladder by avoiding stressing the lower abdominal muscles works for me.
Post op instructions for TURBT/biopsy given to me are:
No heavy activity or sex for 2 weeks.
No lifting over 10 lbs for 3 weeks.
Back off if it hurts.
Easy walking is good, increase as tolerated.

For the scope only - stop if it bleeds or hurts.

Your instructions may differ.

Best
Jack

What's with this Bleeding ? 6/2015
DX: HG Papillary & CIS
3 Years and 30 BCG/BCG+Inf
Tis CIS comes back.
BC clear as of 5/17 !
RCC found in my one (only) kidney 10/17
Begin Chemo; Cisplatin and Gemzar
8/18 begin Chemo , round 3
Begin year 4 with cis

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2 years 1 month ago #53029 by Mistersac
I play a lot of golf, how long after a cystoscopy and biopsy do you wait before you exercise?

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2 years 2 months ago - 2 years 2 months ago #53023 by Jack R
Some doctors feel that the time point for evaluation of BCG effectiveness should be at 3 months for papillary tumours and 6 months for CIS (except when disease progression was observed at 3 months); this implies 6 initial and 2 rounds of 3 x BCG maintenance for CIS. Other doctors may recommend alternate protocols or other intravescial agents or combination of agents. Wide variation of treatment plans have been described on this site.

Dr. Lamm's studies indicate that when BCG has failed to treat CIS, after the above, that restarting BCG may be effective in an additional 14% of CIS cases, assuming tumors remain non invasive. Other agents may also be effective following BCG Failure. There are a number of choices for doctor and patient to consider, based on the specifics of the case.

There is no "stronger" dose of BCG . It is possible to apply too much BCG. It is common to reduce the BCG dose on additional treatments if the side effects are too great. There are procedures that use heat or electric force in the bladder, in combination with medical agents, to increase the absorption of the agent.

Talk to your doctor, ask about both conservative and aggressive treatment plans he can recommend for YOUR situation. If you like, ask for a referral to a bladder cancer specialist to help you decide how you would like to proceed.

Best
Jack

What's with this Bleeding ? 6/2015
DX: HG Papillary & CIS
3 Years and 30 BCG/BCG+Inf
Tis CIS comes back.
BC clear as of 5/17 !
RCC found in my one (only) kidney 10/17
Begin Chemo; Cisplatin and Gemzar
8/18 begin Chemo , round 3
Begin year 4 with cis

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2 years 2 months ago - 2 years 2 months ago #53020 by Alan
Sometimes it is simply another round of 6. Sometimes interfuron is added to the BCG, and sometimes another agent is used such as a chemo/bladder wash. This where you want an experienced URO that is REALLY up to date with what is current and has experience with a wide variety of cases. Believe me, we all have had the same waiting and questions, it is normal and no fun. I'd focus on the fact that for the majority BCG works!

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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