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New to all of this- perioperative chemo???

11 years 6 months ago #5694 by Mike
I would say McJen you don't wanna jump the gun here wait and find out what the results are from the TUR. One step at a time one day at a time. And you did not mention but as I did you want to be dealing with a top notch hospital for this type of thing. Then you can be sure you have excellent Dr's along with a great pathology Dept. What I'm saying is don't let the Urologist just send you to regular run of the mill hospital pick a good one and never hesitate for a second opinion. Good Luck, Joe

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11 years 6 months ago #5691 by Rosemary
McJen,

Just weighing in because I've been through this. I had my first TUR in January 2006 and the second TUR in March 2006.. My doctor treated me with Mitomycin C at the time of both TUR's. I have not had any recurrance in 1 1//2 years. (I've also had 6, 3 and 3 treatments of BCG. since TUR's)

After all is said and done, I am glad that my doctor gave me the Mitomycin, however, I have since learned that my local Urology Clinic has discontinued it's usage .

It's good that you are asking questions.

Best regards,
Rosemary


Rosemary
Age - 55
T1 G3 - Tumor free 2 yrs 3 months
Dx January 2006

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11 years 6 months ago #5685 by wendy

Hello- my boyfriend was just diagnosed with a TCC by cystoscopy, and a TURB is scheduled for this Friday.
It is suspected to be superficial, not yet into the muscle, but will be confirmed during the resection and results from pathology.
I have been reading as much as possible about it and have a question for anyone who migt know- alot of what I've read says that perioperative installation of BCG or MMC has been shown to significantly reduce risk of recurrence.. especially in low-grade tumors..
Is this something that's done routinely now.. or should we be asking about it.. or demanding it when we go for the procedure??? I know that initial/ maintenance BCG/ MMC treatment is suggested depending on grade, etc., but what about the 'perioperative' installation, specifically??
Any help would be appreciated... apologize if I sound ignorant ;)



Hi,

BCG can't be administered peri-operatively, or any other immunotherapy, because there is a wound in the bladder post-TUR. MMC is a chemo drug, and those are the ones used in this setting. This is for low to intermediate grade tumors. BCG is used for high risk, and is a course of 6 instead of 1 instillation.

This is one it's way to becoming a new standard, but not all doctors agree it's necessary. It delays recurrence, but the benefit wears off within a year or two at most.

Did you read this pages on superficial bladder cancer and intravesical chemo?

Keep asking questions..
All the best,
Wendy

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11 years 6 months ago #5684 by Patricia
Gee McJen...it kind of depends on where you are and who you are seeing...the expertise of the physcian .. whether you're at a major cancer facility or not...lots of variables. I personally think it doesn't hurt to have a second opinion whatever the diagnosis...most insurance companies pay for that. And you may get a variance on treatment plans. And certainly we here can be of great service to you as we've seen it all...or at least we think we have until a new kink happens. Most urologists are well versed on Prostate problems....sometimes they don't see a lot of BC. You definately want a physician who has seen a lot of BC and if you should have to go the surgical route you absolutely need a surgeon who does a lot of these..A LOT... what part of the country are you in? Pat

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11 years 6 months ago #5681 by McJen
Thanks very much, Pat. So, I guess as far as the perioperative part.. we should just go with what this particular surgeon chooses, eh?
If it were diagnosed from this doc to be low-grade/ early stage, do you think it would still be a good idea for a second opinion... just to make sure the pathology reports were accurate??

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11 years 6 months ago #5680 by Patricia
McJen.....lots of controversy surrounding MMC perioperatively...some do it...some major cancer centers don't. I would wait until the TURB and stage and grade is determined and then it will be easier to weigh in on treatments. BCG seemingly only effects a few moderately...others its devastating. Don't put the cart before the horse. Make sure you are with a uro/surgeon who routinely does this procedure and that the facility has an excellent pathology department. And with a diagnosis of cancer you always want that second or even third opinion.
Good luck to you.....Pat

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