Iam sure there are risks involved with MMC, if there were a perforation of the bladder. I am equally sure that there are risks if a perforation occurred whilst administering bcg or filling the bladder with saline whilst doing a cystoscopy for example. But the risk of an experienced surgeon or urologist actually perforating the bladder during these procedures is VERY low.I have had MMC post TURB and follow up instillations, and at the moment I am cancer free. I do believe that intravesical chemo works, and would be very sad to think that someone who could benefit from treatment decide not to go ahead with it because of the VERY small risk of a perforation happening.If my surgeon told me I needed to undergo the same treatment again I would have absolutely no qualms about doing it again.
I asked my uro oncologist about this specifically a few weeks ago prior to my mid-June 2008 second TURBT w/ MMC. He said that there was no such ban on use of MMC but that the same caution that has always been in place is still in place: Do Not Use if Perforation or Probability of Perf of bladder exists. Because he was familiar with my bladder (from TURBT #1 in mid-May, he had no concerns about MMC use and did use it on me. That was three weeks ago and I had zero side effects from the MMC that I know of.
My point is...that word seems to be spreading around to local Uro's about the risk of perforation....Mitomycin is getting the BAD rap....
This is the time when I am missing the old forum where I knew where all the threads were to be found....We once also had long discussions about how effective Mitomycin can be in the prevention of recurrence when it is administered within one hour of TURB.
Considering the fact that I have a problem tolerating BCG and that I may not be able to use it as a prophylactic, am I glad I got Mitomycin one hour after ach TURB? You bet....In these cases, you can't go back....
Age - 55
T1 G3 - Tumor free 2 yrs 3 months
Dx January 2006
I do not believe I have heard or read of any change in the discussion of Mitomycin usage, even since your post of a year ago.( I remember the conversation back then). There is "some" risk of the drug entering the system because of perforation of the bladder and becoming toxic. Even though there have been some isolated cases resulting in serious problems, it seems there is still wide spread use of Mitomycin. However, it seems BCG is still the more accepted application.