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First cysto - post TURBT

1 week 4 days ago #58284 by Alan
It certainly sounds like it was a TURB. Those "peek and pokes" cut and burn any thing that can be seen and specimens are sent to pathology. As usual, you won't know much until the path is reported. Yes, if it reads as high grade BCG is probably the agent of choice.

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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1 week 4 days ago - 3 days 4 hours ago #58282 by Knifedealer
UPDATE (new information in bold text):

On 11/15/18 I had 2 low grade papillary urothelial carcinomas (negative for lamina propria and muscularis propria invasion) removed. Surgery included an instillation of MMC. Both tumors were 1 CM or less. This was caught early. I was asymptomatic for bladder cancer. The cancer was found only incidentally during a cystoscopy that was conducted to observe/gauge prostatic enlargement.

On 3/4/19 & 6/4/19 post-TURB cystoscopys were normal except for a small patch that appeared inflamed. My urologist said it could be irritation from the mitomycin instillation or could be the precursor for a new tumor(s).

On 9/6/19 during my third post TURB scope we found what almost certainly looked like (can't be sure until after pathology exam) a "very very superficial" recurrence. Doctor said the area in question appeared to be less than 1 CM and chances are its the same "type of pathology" as what was removed initially (see 11/15 above). I await a call to schedule the biopsy and will update once the pathology report from that procedure is received.

EDIT: biopsy scheduled for 10/24/19.

While the doctor referred to the upcoming procedure as a "biopsy," couldn't this also be characterized as a TURB? If not, what's is different? I assume all of the questionable tissue and some tissue that underlies the atypical tissue will be excised, just as before. I guess my question is: isn't a TURB simply a biopsy, albeit confined to a biopsy of bladder tissue?

A positive thing to note: each cystoscopy seems to be less painful that the last. While the first found me a writhing and whining mess, the most recent could only be described as somewhat uncomfortable. Admittedly 5 mg of diazepam taken prior to the last 2 procedures allowed me to relax and made for easier insertion of the flexible shaft.

Finally, it looks as if my bladder now becomes a candidate for some sort of therapeutic agent, administered intravesically: either BCG or gemcitabine. Admittedly I'm feeling a bit sorry for myself.

Until next time ... My Best to All.

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6 months 2 weeks ago #56993 by Alan
Thanks for the updates! It helps everyone. I would guess the "napalm" is the irritant! As always just keep the followups.

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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6 months 2 weeks ago - 6 months 2 weeks ago #56992 by Knifedealer
Just checking back, in part because I said I would, in part because this forum is the best chronicle I have to track my process, and in part maybe my experience may help others.

I had my first post-TURB cystoscopy today, Monday, March 4, 2019. In November 2018 a TURB was performed to remove 2 small (1 CM or smaller) low grade papillary urothelial carcinomas that were both negative for lamina propria and muscularis propria invasion. When I received the pathology report, I presumed I would be obsessed with my condition for the foreseeable future. This has not been the case. In fact, there are times when I forget entirely that I am being treated for cancer. So, at least until now, cancer hasn't ruled my every waking moment.

I understand that for some, a cystoscopy is only mildly annoying while others find it agonizingly painful. My first cystoscopy (when the tumors were found) was more of the latter. I'm happy to report that today's procedure was significantly less painful and clinically mostly unremarkable. While no evidence of tumor recurrence was noted, my urologist did find an area that appeared inflamed and the area was clearly more vascularized than the rest of the interior bladder wall. He said it could be irritation from the mitomycin instillation or could be the precursor for a new tumor(s) as tumors need a blood supply. Since the mitomycin caused significant burning and pain for a week or 2 after the TURB, I'm sure (wink, wink) the suspect area is "just" irritation caused by the napalm ... err ... I mean mitomycin.

So I'm going to continue living life in a very big way until June, when I get to see my urologist again for another cystoscopy.

Thanks for your support and best of luck to all.

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