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7 years 7 months ago #41425 by maryland_mike
<strong>maryland_mike wrote:</strong>

<strong>maryland_mike wrote:</strong>

<strong>maryland_mike wrote:</strong>

<strong>maryland_mike wrote:</strong>

<strong>maryland_mike wrote:</strong>

Update #3 - had 4th BCG two days ago. The last two BCGs have produced more pronounced side effects - mainly lots of blood in the urine for approx. 8 hrs, starting approx. 4 hrs. after each treatment (then it clears up). A dull ache in the urinary tract and testicles is also noted. I also have felt like I'm coming down with something, with minor chills and a low fever (99), about the same duration as the bloody urine. My uro says that's a good sign the BCG is working - looks like Mssr. Calmette and Mademoseille Guerin are ripping me a new bladder! (:<) Two days after each treatment, I feel great - no more after-effects, other than quick and strong urge to urinate. Two treatments to go!!!


Add-on: At the 4th BCG session, my uro said he prefers to do another TURB at the 6-wk. post-BCG point instead of just another cystoscopy. I like this idea, as there are articles in the literature confirming frequent benefit of a 2nd TURBT after the first. It's worth another outpatient surgical visit to me.


Update #4: Had 5th session yesterday. Same after-effects as in 4th - even same fever reading. I feel a little more rundown this morning than in previous treatments. ONE TO GO! The doc doesn't want to decrease dosage - neither do I. Have a great week, everyone!


Update #5: BCG ALL DONE (for a while)! Had 6th and last treatment yesterday. This one gave me the most notable side effects - had a fever of just over 100 last night, and had a hard time making it to the toilet without dribbling (got up 5 times). Not as much bleeding this time, though - just flesh chunks. Felt worn out today, but no fever, and toilet habits are improving. I'm scheduled for a cysto/TUR on 1 Feb, and this will be with full anesthesia so the doc can use the Holomium laser if needed. He also is concerned about the diverticulum, and wants to be able to do anything needed regarding it (except removal - that will come later, if needed). I'll start a new thread after my cysto.

Merry Christmas and Happy Holidays, everyone!


Update #6: Had a bladder cysto/biopsy on 2/1 to check on the BCG results. Main part of bladder was CLEAR! My uro said it was "beautiful" - I saw the scope pics, and indeed, where papillary tumors were present before the TURBT and BCG, it looked perfectly smooth and even-colored. HOWEVER.......
I have a divertilulum, as stated on my first entry. Unfortunately, there is a tumor inside this ~2cm diverticulum - maybe the BCG couldn't reach it (my guess). So - I am having a diverticulectomy and partial cysectomy of the bladder close to the mouth of the diverticulum. I'm having this done by the head of urological oncology, Dr. Mohan Verghese, at Washington Hospital Center, so I fell I am in good hands. I have another cysto/biopsy tomorrow so Dr. Verghese can plan the surgery, which will be done by a ROBOT! Yes, I will have a date with the Da Vinci robot in the near future. My hospital stay should be only 2-3 days, thanks to the laparoscopic technique used with the robot. I will post my impression of the experience.

Cheers to all!


Update #7: I'm pinching myself that today is only Wednesday. On Monday, less than 36 hours ago, I had my diverticulectomy/partial cystectomy done, and I have truly been part of one of the miracles of modern medical science. As part of treatment for my bladder cancer, I needed a bladder diverticulum with a tumor in it removed. The procedure was done this Monday using the Da Vinci robot (and very skilled robotic surgeon operators, of course), and I was discharged from the hospital yesterday - yes, only a 1-night stay - after this major bladder surgery. I should be cancer-free - at least for a while - now (later tests will show), as after the BCG treatments no cancer cells were found on the bladder wall.

I highly recommend to anyone needing internal major surgery to investigate the use of the Da Vinci robot (Google it for more information - there's lots out there).

I face maintenance BCG treatments in a few months, with constant moitoring, of course. I will keep posting on my progress.

By the way - I learned during my surgical ordeal that there is an acute shortage of Mitomycin C in the U.S. My urological oncologist had planned to use a single dose of Mitomycin C during the diverticulectomy as a safeguard against any cancer cells that might have "leaked" from the tumor while it was being removed. Unfortunately, there was none to use, and he said there was an acute shortage - and also a shortage of BCG - throughout the country. He said the combination of my low-grade tumor, plus his careful avoidance of leakage and the thorough washout they conducted, would hopefully prevent any stray cells from leaking into my abdominal cavity. Here's hoping!

Cheers - Maryland Mike

TURBT, HoLAP, bladder stone ablation 9/28/11
Ta, Mx, Nx

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7 years 8 months ago #41042 by CatherineH
Hello Mike... I had a partial cystectomy at Vanderbilt in Nashville two years ago this month via traditional open surgery. The surgery was on Thursday and I was discharged on Sunday. Mine went well and I had virtually no issues during my recovery. I would expect the same for you, and maybe even faster healing if the robotic surgery is a little less invasive.

Best wishes...
Catherine

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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7 years 8 months ago #41040 by maryland_mike
Thanks so much for the sage advice, Sara Anne. I agree that the "man at the controls" is the most critical part of the Da Vinci system. The urologist performing the surgery has excellent credentials (he's head of urological oncology at a major regional hospital, and will be assisted by another Da Vinci expert during the surgery. I did not yet ask him how many procedures he has done, but I will do that before the surgery is scheduled.

Compared with the alternative (open surgery, with a probably longer recovery and hospital stay), I am excited to undergo this procedure. Perhaps being a retired computer engineer has incresed my interest ;)

Cheers - Maryland Mike

TURBT, HoLAP, bladder stone ablation 9/28/11
Ta, Mx, Nx

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7 years 8 months ago #41039 by sara.anne
Yes, the da Vinci procedure is the very latest BUT there are some cautions here. It is not the procedure, but the expertise of the guy doing it that is important. As this has become the very latest thing, too many hospitals have spent multi$$$$$ on these machines and then put pressures on their physicians to use it to recoup the $$$$. I, personally know of one medical center where a wealthy grateful patient actually GAVE one of these machines to the cardiology department. The cardiologists weren't quite ready to adopt the procedures and ended up giving it to the urology department, which then happily did tons of procedures...some not very successfully.

AS mentioned above, IT IS THE EXPERTISE OF THE SURGEON WITH THE APPARATUS THAT COUNTS. How many has he/she done? Where did he/she get the training? I have a friend who is a senior urologist who is spending a YEAR at the Cleveland Clinic obtaining training in this area. It is not something to be picked up at a seminar somewhere. My internist had prostate surgery with "the best guy in town" this way and is NOT a happy camper.

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator

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7 years 8 months ago #41037 by upnorth
Thanks for the update Mike.

You have cronicaled your journey very well. This a good thing to do, so others can see the steps that are taken and when.

The Di-Vinchi knife I have only just heard of, but it sounds like its the cutting edge. (No pun intended)

I hope all goes well for you. And keep up the good posting.

Mark

Age 55
Diagnosed BC 12/20/2011 Ta No Mo 0a Non-Invasive At age 48
"Please don't cry because it is over..... Smile because it happened!" {Dr. Seuss} :)

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7 years 8 months ago #41034 by maryland_mike
<strong>maryland_mike wrote:</strong>

<strong>maryland_mike wrote:</strong>

<strong>maryland_mike wrote:</strong>

<strong>maryland_mike wrote:</strong>

Update #3 - had 4th BCG two days ago. The last two BCGs have produced more pronounced side effects - mainly lots of blood in the urine for approx. 8 hrs, starting approx. 4 hrs. after each treatment (then it clears up). A dull ache in the urinary tract and testicles is also noted. I also have felt like I'm coming down with something, with minor chills and a low fever (99), about the same duration as the bloody urine. My uro says that's a good sign the BCG is working - looks like Mssr. Calmette and Mademoseille Guerin are ripping me a new bladder! (:<) Two days after each treatment, I feel great - no more after-effects, other than quick and strong urge to urinate. Two treatments to go!!!


Add-on: At the 4th BCG session, my uro said he prefers to do another TURB at the 6-wk. post-BCG point instead of just another cystoscopy. I like this idea, as there are articles in the literature confirming frequent benefit of a 2nd TURBT after the first. It's worth another outpatient surgical visit to me.


Update #4: Had 5th session yesterday. Same after-effects as in 4th - even same fever reading. I feel a little more rundown this morning than in previous treatments. ONE TO GO! The doc doesn't want to decrease dosage - neither do I. Have a great week, everyone!


Update #5: BCG ALL DONE (for a while)! Had 6th and last treatment yesterday. This one gave me the most notable side effects - had a fever of just over 100 last night, and had a hard time making it to the toilet without dribbling (got up 5 times). Not as much bleeding this time, though - just flesh chunks. Felt worn out today, but no fever, and toilet habits are improving. I'm scheduled for a cysto/TUR on 1 Feb, and this will be with full anesthesia so the doc can use the Holomium laser if needed. He also is concerned about the diverticulum, and wants to be able to do anything needed regarding it (except removal - that will come later, if needed). I'll start a new thread after my cysto.

Merry Christmas and Happy Holidays, everyone!


Update #6: Had a bladder cysto/biopsy on 2/1 to check on the BCG results. Main part of bladder was CLEAR! My uro said it was "beautiful" - I saw the scope pics, and indeed, where papillary tumors were present before the TURBT and BCG, it looked perfectly smooth and even-colored. HOWEVER.......
I have a divertilulum, as stated on my first entry. Unfortunately, there is a tumor inside this ~2cm diverticulum - maybe the BCG couldn't reach it (my guess). So - I am having a diverticulectomy and partial cysectomy of the bladder close to the mouth of the diverticulum. I'm having this done by the head of urological oncology, Dr. Mohan Verghese, at Washington Hospital Center, so I fell I am in good hands. I have another cysto/biopsy tomorrow so Dr. Verghese can plan the surgery, which will be done by a ROBOT! Yes, I will have a date with the Da Vinci robot in the near future. My hospital stay should be only 2-3 days, thanks to the laparoscopic technique used with the robot. I will post my impression of the experience.

Cheers to all!

TURBT, HoLAP, bladder stone ablation 9/28/11
Ta, Mx, Nx

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