Biospy Results - 6 week BCG

Hi Mike,
Thank you for your reply. We too have been told that the protocol is bladder removal if the 2nd round of BCG + Interferon does not result in a negative biopsy report. The strange thing for my husband is that his local urologist believed in continued treatments with BCG and did two more rounds. In brief, his history goes like this: Feb 2013 – CIS discovered, 6 BCGs given; June 2013 no invasive carcinoma seen, 6 BCG + Interferon given; Nov 2013 small malignant tumor in situ removed followed by 6 BCGs; Feb 2014 all biopsies negative, 3 BCGs given; April 2014 all biopsies negative; July 2014 all biopsies negative. I guess we are waiting to see cancer return before being comfortable with bladder removal and the lifestyle change it will cause. Others, I realize, would opt for removal immediately if a Cleveland Clinic urology oncologist told them it was imperative to do so for best overall outcome. Statistics say there is a 30-60% chance of recurrence. How would one know if they are in the percentile that it does not recur? Our local urologist told him that bladders have been removed and biopsied and proven to not have cancer. He used to remove bladders himself but now only removes kidneys and prostate. We haven’t asked him directly but we suspect he opted not to follow Cleveland Clinic’s protocol of removing a bladder even if the biopsy reports show all negative, just a speculation on our part. While my husband has not yet made his final decision, you may want to check back with us in the future to see what he decided and how he faired which may help you if you arrive at this point of having to make a decision for Radical Cystectomy or to continue with surveillance until cancer shows again. The risk of course is that it could reappear with a vengeance and also break through the bladder wall becoming invasive vs. his current stage of non-invasive. Such a hard decision. We wish the best of luck to you with the 2nd round of BCG, and please let us know if we can answer any questions you may have as you continue with this battle. Laurie & Phil 8/5/14

Laurie & Phil,

My 2nd round of treatments didn’t go as well as the 1st, after the 3rd treatment in the 2nd round I had to stop the BCG. By bladder has a severe reaction and we were at a 1/3 dose, I finished the last 3 treatments with Interferon only. I will have another biopsy at the end of August o see where I’m at. If I’m clear we will have to do something else for the maintenance program. If I still show cancer on the biopsy we will try one more round of treatments using Valrubicin. My Uro has stated that we have some options but he has prepared me that I may have to have the bladder removed.

Good luck & best wishes to your husband!

Mike

Hi Mike,
How are you doing with treatment? My husband has CIS of the bladder. He has had a total of 20 BCGs (March 2013-Jan 2014); second round included interferon. His cystoscopies and biopsies since February of this year (18 biopsies) have all been negative and his most recent CT and chest Xray in July were negative! Wonderful news, right? Well... our dilemma is that the Cleveland Clinic surgeons are insisting he must have his bladder removed, stating that "statistically" the cancer "will come back". We've been told he is playing Russian Roulette by not having it removed. He is still at stage 0, non-invasive. What have you been advised for future surveillance and treatment?
Laurie & Phil

Thanks Alan, we will be including interferon this round. I'm feeling positive about this next 6 treatments getting the rest of the cancer

I finished my 6 weeks of BCG treatments for Carcinoma in Situ and got the biopsy results back. Before treatment I have a very large area of the bladder that was affected with very bad and painful symptoms. The biopsy results came back showing that most of the cancer is gone however there is still a small area showing cancer.

Next steps are to begin a second round of 6 treatments beginning next week, I'm ready for that and optimistic since my system reacted well with some positive results the first round.

Reality check was my urologist talked to me today about bladder removal if this second round doesn't get rid of it all.

6 more treatments, 1 more biopsy and hopefully some more good news.

Regards,
Mike