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BCG or Cystectomy?

3 years 4 months ago #50629 by Alan
Mike,

I didn't have CIS although the rest of your story is similar to mine. It is good that your Doc is conservative. For my $$$ MD Anderson would be a quick step. I know in many situations you can self refer. Anyway, good luck and thanks for your past service.

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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3 years 4 months ago #50625 by Mike M
Thanks Sara Anne,

Excellent point...the Mitomycin was a one-time treatment after both the 1st and 2nd TURBTs. I note you've had success with BCG treatment for CIS which gives me hope. I'm resolved to fight this, pursue the BCG treatment, and avoid the RC as long as feasible. Appreciate your comments and support very much.

Regards,

- Mike

Dec 15 - DX Ta HG, 1.5cm Pap, Focal CIS; Treatment: SWOG Protocol (BCGx27); Feb 19 - Ta HG recurrence and CIS/Ta HG in right kidney/ureter; underwent nephroureterectomy; next cysto in May

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3 years 4 months ago #50624 by sara.anne
Mitomycin was given once following TURB? That is a rather common practice to avoid "seeding" any more cancer during the TURB. It is not usually considered a "treatment" for any type of bladder cancer. Or did you have several weeks of mitomycin following the TURB? Sometimes when BCG is not available this is done. Mitomyin is not usually nearly as effective as BCG.

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator
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3 years 4 months ago #50618 by Mike M
Thanks Alan,

Believe my Uro is concerned that despite intravesical Mitomycin following the first TURBT, the original Ta tumor restaged up as T1, plus CIS is now present after the 2nd TURBT. Since now being diagnosed as T1, CIS (after Mitomycin), he thought the timeframe w/BCG treatment might be too risky, because if it did not work, with CIS the probability of metastasis is too great. Said CIS doesn't necessarily follow at T1,T2,T3 straight linear progression...but can leap to T4 very rapidly. In any case, sincerely appreciate your comments and support!

Dec 15 - DX Ta HG, 1.5cm Pap, Focal CIS; Treatment: SWOG Protocol (BCGx27); Feb 19 - Ta HG recurrence and CIS/Ta HG in right kidney/ureter; underwent nephroureterectomy; next cysto in May

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3 years 4 months ago #50617 by Alan
Mike,

While BAMC is well respected I almost question why the doc wants an RC without trying BCG. Has he handled a number of bladder cancers? I live in New Braunfels so I am a little familiar with all the places you have mentioned. Being so close to MD Anderson I would certainly look toward a second opinion there. I have friends that have used Dr. Kamat and I think a Dr. Grossman and Denney still practice there and all are highly rated. Ironically, Dr. Donald Lamm (now in Phoenix) pioneered the usage of BCG at the UT Health Center.

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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3 years 4 months ago - 3 years 3 months ago #50616 by Mike M
Hello Friends,

Just an update. Met with military Uro today at BAMC to discuss pathology rpt and treatment options. Path report revealed T1 and CIS. Uro still recommends RC for best probability of survival, and believes BCG (in my case) is a big gamble. Supports pursuing second opinion, so this is my current approach. From the forum's "treatment center finder", will check with CTRC in San Antonio and possibly MD Anderson in Houston...both are under UT Health Science.

Sincerely appreciate everyone's counsel, advice and wisdom.

Regards,

Mike

Dec 15 - DX Ta HG, 1.5cm Pap, Focal CIS; Treatment: SWOG Protocol (BCGx27); Feb 19 - Ta HG recurrence and CIS/Ta HG in right kidney/ureter; underwent nephroureterectomy; next cysto in May

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