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Radical Cystectomy for T1

2 months 1 day ago #58138 by NelsJenn
I am at the same point you are in. I had my third BCG intravesical infusion yesterday and am hoping these treatments will keep the bladder cancer at bay. My urologist has gone over the statistics of the BCG working and the option of an R/C at this point.

In my case, getting an R/C would eradicate the cancer, since the cancer has not spread through the bladder muscle wall. With that said, an R/C would drastically change my life. It's like nipping the cancer forever, but creating another life changing element in your life. Is this option of getting rid of the bladder cancer worth the change in the quality of life?

Many doctors and bladder cancer patients feel it's not, especially when you consider the effectiveness of the BCG treatments. I say this knowing that the BCG treatments are a long term commitment (at least 5-10 years).

Is there a risk with the cancer spreading beyond the muscle walls while doing the BCG treatments? I suppose if the BCG treatments don't stop the cancer, my doctor would tell me before the cancer spreads beyond the muscle walls and there would be time to change course and implement a R/C. But even with this, there are no guarantees.

I have decided to have faith with the BCG treatment because of the experiences of other bladder cancer survivors. And the statistical numbers enforces this. As Alan stated, there are no guarantees and it's one day at a time.

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2 months 2 weeks ago - 2 months 2 weeks ago #58050 by Alan
IF BCG works yes, you should be able to move on with the bladder intact. It worked for me and I am 11 years post. I would simply give it a chance considering how rigorous and life changing a cystectomy is. There are no guarantees in life, BCG or cystectomy. At the same time if mine had come back I was prepared and still am should there be a recurrence. As per my previous post the odds are with you BCG works

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 months 2 weeks ago - 2 months 2 weeks ago #58049 by ehsanb
Thanks for your replies. So by reading your replies if I understand correctly BCG treatment plus moderate surveillance at this is stage won't let a new born tumor metastasize beyond the bladder. Because if there is a chance of this I would rather R/C now rather than later.

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2 months 2 weeks ago #58043 by Alan
Welcome,

I have learned in life there are no guarantees. To answer directly to your question about BCG and
or a cystectomy. The higher the stage the less getting cured as with most cancers. At stage 1, I personally feel BCG or other agents at least gives one a better than 60-75%+ chance of beating this back. Statistical studies support that. IF it becomes stage 2 or higher then cystectomy is proven to give one the best chance of beating it back. There are many on this board that have been stage 0 or 1 and been around 10+ years. Myself included. It is easy for me to say now but, take life one day at a time including this cancer thing. It has made me stronger and more effective in my life. You will do fine.

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 months 2 weeks ago #58042 by sara.anne
Guess I don't quite understand why you are considering radical cystectomy if the BCG is working?

Anyway, to answer your question, IF the time comes to consider such a thing because BCG has failed, of course bladder removal can prevent the cancer from returning. In cases where it does return it is because it had already metastasized beyond the bladder.

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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2 months 2 weeks ago - 2 months 2 weeks ago #58040 by ehsanb
Hi, I recently diagnosed with high-grade bladder cancer stage 1 and the good news is it hasn't invaded the muscle. Today I've done my second round of BCG therapy that seems to be the best option for me right now.

My question is if i do radical cystectomy at this stage, would it cure the cancer meaning it won't come back ever again? If it does comeback where does the tumor going to appear since there won't be any bladder anymore.

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