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CIS Remains After 6-Wk BCG Induction

2 years 4 months ago - 2 years 4 months ago #51805 by Alan
Thanks to Mike and Sara Anne,

Glad to read about the University system and BAMC. I know the highly regarded Dr. Lamm taught and/or practiced in San Antonio many years ago(he even taught my URO from nearby New Braunfels). Mike, let's just hope and trust another round of BCG with interfuron does the trick. I continually learn from everyone on this board!

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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2 years 4 months ago #51803 by sara.anne
The CTRC at the University Hospital in San Antonio is a pretty good place, and Dr. Svatek appears to have all the right credentials. You are fortunate to have this available. Unfortunately, I am personally familiar with the TRICARE system. However, once you transition to Medicare and TRICARE For Life it is GREAT!!!

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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2 years 4 months ago #51801 by Mike M
Thanks Alan,

Interestingly, the CTRC has an MD Anderson-trained bladder cancer specialist here in San Antonio...Dr Robert Svatek. I plan to seek a 2nd opinion from him, but not sure if Tricare will cover the cost. I'll just cover it myself if necessary.

Almost like a "catch-22"...requested a 2nd opinion referral earlier through my PCM (Primary Care Mgr), and it went straight to the BAMC Urology Dept where I'm being treated now. Apparently under Tricare I can only get a referral to MD Anderson or the CTRC (or anywhere for that matter) if the level of medical service required is deemed beyond the availability or scope of BAMC. This applies to 2nd opinions on diagnosis, treatment, pathology and surgery. BAMC believes they can cover all those areas. Not sure how many RCs are performed at BAMC, but suspect it's not as many as an NCI designated hospital. That's why I was hoping to hold out until next year when I turn 65 and can go on Medicare. Then going to MD Anderson or CTRC wouldn't be a problem.

12/15 - DX - Ta HG, 1.5cm Pap, Focal CIS; Treatment: SWOG Protocol...currently BCGx27

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2 years 4 months ago #51800 by Mike M
Thanks Jack,

Yes, our paths seem very much alike as do our treatment approaches. Thanks for the two articles, and you're absolutely right...a tough decision...choose pre-emptive RC now or continue to "dance around the fire". I'm hoping one more 6-wk BCG course (with perhaps interferon added) will produce NED, before the "cat gets out of the bag."

Best wishes,
Mike

12/15 - DX - Ta HG, 1.5cm Pap, Focal CIS; Treatment: SWOG Protocol...currently BCGx27

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2 years 4 months ago #51799 by Alan
Mike

I am not up to speed with Tricare rules. However, if you are allowed to get to MD Anderson in Houston I'd reach for that hospital.

Thanks for your 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.
The following user(s) said Thank You: Mike M

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2 years 4 months ago #51798 by Mike M
Thanks Sara Anne.
As a military retiree, I'm being treated at Brooks Army Medical Ctr in San Antonio under Tricare (Humana). Scheduled to meet Urology Dept resident next week to discuss path rpt and way ahead. My staff urologist has been recommending RC since day one. Will discuss possibility of one more 6-wk BCG induction course with interferon as you mentioned. Will also discuss getting a 2nd opinion from the NCI designated CTRC here in San Antonio. Would have already been seeking treatment at the CTRC, but Tricare requires you seek care at military facilities first (if capable of providing the medical service needed). Was hoping I could kick the can down the road at least until next year when I turn 65 and go on Medicare. Then I could seek care at the CTRC with no problem.

12/15 - DX - Ta HG, 1.5cm Pap, Focal CIS; Treatment: SWOG Protocol...currently BCGx27

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