Recurrences no visible blood

It's not unsual for recurrences to occur without visible hematuria. Once reason is that prior to our first TURBT, tumors can grow pretty large with extensive blood supply (hence visible blood). Like many, I had lots of blood initially.

However, with ongoing surveillance (cystos and the like), tumors are usually caught at a much earlier stage (hence the prevalence of microhematuria).

That's one reason why so much research is ongoing to find the 'perfect' test for detecting recurrences (FISH and cytology for high-grade cancer...).

The downside is that for folks that are post-RC (like me), a large percentage of upper tract or urethral recurrences are missed by ongoing surveillance testing. The patients themselves come in with symptoms (pain, visible blood...) The bad news is that early vs later detection of upper tract recurrences for post-RC folks doesn't make much of a difference in outcomes.

Yeah, yeah, yeah, I know I'm preaching - so stop reading if you know what's coming, but that's one reason it's so important to aggressively treat high-grade blc. The sooner 'superficial' blc is dealt with curative intent, the less likely recurrences are.

Rosie,

Thanks -- that does help. I will call and request a printout on my cytology. So the presence of both transitional and squamous cells did not necessarily indicate a recurrence in your case, just more watchful waiting? I still have much to learn about all of this which is probably why my Dr. does not usually spend much time trying to explain things to me. But through all of you on this forum I have increased my knowledge of BC treatment exponentially.

David

David,

As far as no visible blood seen for recurrences: I am referring to recurrences after their initial TURB and no additional treatment is done but rather another cystoscopy at 3 or 6 months. I and many have experienced recurrences but no visible blood. None of the people I have been in touch with over the years had visible blood signaling a recurrence under those circumstances. I have had 4 recurrences and no visible blood. My original tumor had much visible blood over a period of 4 years before it was diagnosed. Everyone I have been in touch with long term were the same. Lots of visible blood with original tumor but no visible blood for recurrences. The blood in your urine could still be attributed to your recent BCG treatments. I believe BCG can have affects for up to six months. I don't know if CIS recurrence presents itself differntly. Anybody? I remember my lab consultant giving me a print out on urine cytology test and what can affect the reading. Recent BCG treatments was one of them. I posted the other things that can affect urine cytology. You and others can read that post here blcforum.com/smf/index.php/topic,598.0.html Hope that helps. Rosie

I have been reading these posts about what exactly blood in the urine (both visible and microscopic) may indicate. I had my TURB (TA papillary tumor plus CIS) three and a half months ago, followed by 6 BCG treatments which were completed about 8 weeks ago and have had quite a few very visible incidents of blood and some small clots in my urine, mainly late afternoon only. I'm awaiting results from a cytology test which will show whether cancer antigens are present.
I assume what Rosie meant was she didn't know of blood in urine indicating a recurrence where LOW GRADE cancer had previously been treated. Perhaps this is not so with CIS?

David

Greg,

I have yet to learn of anyone with low grade who had visible blood as the first indication of recurrence. Those of you constantly looking back at the urine or refraining from urinating in the dark - Take Note. Rosie

My TURBT last week removed a recurrence from a Jan 2007 diagnosis. I had microscopic blood only noticeable by my urologist under a microscope. I've read of many people not noticing blood before their recurrences were noted.

Christopher, props to the urinalysis strips. I also investigate my urine like a hawk, oftentimes calling in my wife to look at it. Now that I have had this recurrence with no visible urine, I'm just gonna start going again and only pay attention when it really turns a different shade.