How bad is it

17 years 8 months ago #790 by skypilot
Replied by skypilot on topic How bad is it
Thanks for your input, I will see the second half of the robotics surgery team on the 13th of July, then we will most likely try to have it removed in Augest hopefuly it is still contained in the bladder. Don

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17 years 8 months ago #789 by cta7978
Replied by cta7978 on topic How bad is it
So the ? is how long does it take to progress into a state that it will mastise. I guess it is an unknown. Don


I believe statistically people that have stage T1 and remove their bladder have a ~90-95% 5 year survival rate, that would translate to apporximately a ~5-10% chance of metastatic cancer after the bladder was removed.  

If the tumor progresses to a T2 the 5-year survival rate drops by another ~25% to 65% after bladder removal

Since these are the statistics of survival after bladder removal, its easy to deduce that tumor metastasis has already occurred in ~5-10% of patients with a T1G3 upon bladder removal or TURB and ~35% of patients with a stage T2 muscle invasive tumor upon bladder removal , it just doesn't present until 0-3 years later.

If you wait too long and the tumor reaches stage 3+ then the 5 year survival odds drop even more significantly.  So to answer your question, the longer you have a residual or recurranct tumor in your bladder the higher your chances are of it metastisizing.

Again the statistics I quoted are just off the top of my head, verify with a real dotor.

Chris A.
Diagnosed T1G3 - 3/01/06
37 yo, Seattle, WA

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17 years 8 months ago #787 by cta7978
Replied by cta7978 on topic How bad is it
Oh, went back and read a few of your posts, you originally presented with multifocal T1G3, this is a recurrance after 6X BCG.  Well, hate to say it, but your urologist is probably justified recommending bladder removal.  However, it all comes down to you and how much your willing to risk.  If you do have a T1G3 and it was completely resected, you could do one more 6X BCG, and hope that they removed all of the tumor this time.  You could try with BCG + Inf. or you could do a bladder sparing protocol with radiation/chemo.

These are all choices you can make/explore if you want to save the bladder.  Your current urologist probably suspects that the T1G3 was not completely resected and may have invaded the muscle (i.e. its actually a T2G3).  You indicated that one urologist wants to do another TURB, that indicates to me that he is still looking at the possibility of saving the bladder.

Statistically if you have the bladder out while the tumor is still superficial (i.e. Ta or T1) you probably have a 90-95% cure rate, if you chance it and it progress to a T2 or T3 you might only be looking at a 65% cure rate.. Either way you lose you bladder and have all the associated morbidity with that. (Those statistics were just off the top of my head, check with your urologist for the actual stats).

So you can take the safest way out and remove the bladder now or take on additional risk and keep fighting the T1G3 until it either is cured or actually does progress and then you take the bladder out anyway but have a lower survival rate.

Good luck.

Chris A.
Diagnosed T1G3 - 3/01/06
37 yo, Seattle, WA

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17 years 8 months ago #782 by skypilot
Replied by skypilot on topic How bad is it
The Doc says path report says it is T1 but in his experance conciders it t2 he does not want to treat it due to location between kidney drain and pee tube. I dont mind so much having the surgery I just cant do it now. So the ? is how long does it take to progress into a state that it will mastise. I guess it is an unknown. Don

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17 years 8 months ago #781 by cta7978
Replied by cta7978 on topic How bad is it
Maybe I am reading it wrong, but sounds like you had high grade invasion of the lamina propria, which I would read as T1G3. It sounds like a sample of the musculais mucosae was included with the TURB specimins, and was clear of cancer invasion. So I am assuming your not dealing with a T2? Or does the Uro believe it may be a T2?

As I understand it, generally if you have a T1G3 recurrance within 6 months of BCG therapy its generally considered a BCG failure and many urologists proceed with removal of the bladder/prostate. I'm not sure from your pathology summary if you had a single new occurance or a recurrance from the original site. If the recurrance happened at your original TURB site, then its pretty obvious that the first tumor resection was not actually complete.

If your looking for alternatives to having the bladder removed, you might want to talk to your doctor about BCG + Inf treatments (Per Dr. Odonnell). There are other bladder sparing protocols you can look into as well (i.e. radiation + chemo).

Chris A.
Diagnosed T1G3 - 3/01/06
37 yo, Seattle, WA

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17 years 8 months ago #779 by skypilot
How bad is it was created by skypilot
:-/  My last turb path report done on May 3 after 6 bcg. showsA and C three of the biopsy pieces (A) contain foci of high grade ureathial carcinoma that invades the lamia propria. the  foci range from 0.02 to 0.3 CM. Adjacent to carcinoma in one piecesis a small amount of Muscle that appears most consistant with musculais Mucosae. (what is this) No difinite muscularis propria is Idenified in Biopsies. In Tr (specaman C) are at least Five additional pieces of tiisue with Foci of high grade ureathelial carcinoma that range from 0.1 to 0.5CM. The carcinoma again invades the lamina propria and has a few associated small muscle fibers consistent with muscularis mucosae. The resection also contains several pieces of tissue with unequvioal muscularis propria that shows no invasive carcinoma. I have been gettig second and third opinions and will have anther soon you know everyone knows agreat uro. My guy told me on My 9 that i should get bladder out by end of June. That did not happen becouse I have been looking into robotics surgery, Now one Doc wants to do anther TURB and still another says with 3 more BCG I can do it in fall I am into concrete as my work so want to do it when my head is clear. My tumers is located between my uriters and ureatha. That is Doc no 1 concern. cat shows all normal and path reports show all other organs are normal including prostaeand ureatha. So sorry for my speeling. Thanks in advance for input into my delema. Don

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