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diagnostic tests

13 years 3 months ago #540 by amy
Hi Wendy

Thanks for the reply. My post may have been a little misleading. The urologist saw the bladder tumor first on my IVP films. I had an IVP done two weeks after delivering my son. I had had blood in my urine throughout my pregnancy. The doctor's office would not even mention the blood unless I asked whether or not there was blood in my urine. My GP ordered an IVP and referred me to a urologist with great hesatation. She thought I had post partum depression and felt I was worrying about nothing. The radiologist noticed a dialated right ureter and Kidney which are normal changes due to pregnancy. However, he failed to mention in the report the lesion in my bladder. MY GP called me to let me know the IVP was normal. She said I did not need to go to the urologist. Being that they had already referred me I took my IVP films a week later to the urologist. He looked at the films and saw the lesion. He was very concerned by my symptoms and the amout of UTI;s I had had during my pregnancy. He did a csyto that morning and told me about the superficial bladder cancer. 6 days later I had a TURB. Then he was able to give me a concrete diagnosis. He is planning on doing a UA and a csyto every three months for the next year. When I referred to test I meant CT scans or MRIs to confirm that the tumor had not spread. I spoke with the urologist this morning and he confirmed that this type of tumor at this stage could not have metastasized. I feel like if I had not been pregnant and having my urine checked for blood I would never have known I had the tumor. It really bothers me that the doctors would not even mention the blood until I asked. They would just reassure me that it was nothing serious. The only serious cause for hematuria would be cancer and I was too young for that! I am glad I listened to my instincts and my father who is a veternarian who did not think my IVP fils looked normal.

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13 years 3 months ago #539 by wendy
Hi,

I'm surprised to meet someone so young with TCC but there are more of you out there, I"m sorry to say.

Your diagnosis of superficial, non invasive TCC is a very common one, doctors are almost always able to diagnose this from the way it looks, though biopsies are done to confirm. Removal and no other treatment is more or less standard for a low grade papillary tumor. Because of the physiology of the bladder and its lining the cancer doesn't enter the blood stream or lymph system unless it's an aggressive, invasive sort of tumor. These are also easily diagnosed by the way they look but biopsies are needed to make a definite diagnosis with any cancer.

Do I understand you to be saying the doctor did not remove the visible tumor and do a biopsy and pathology? This would be an unusual move, but not without precedence, as recently updated on the main site:

Update 2006: Two articles support 'watchful waiting instead of automatic removal of low grade superficial bladder tumors:
Expectant treatment of small, recurrent, low-grade, noninvasive tumors of the urinary bladder,.."As long as the tumors are low grade, the risk of invasion or metastasis is zero. Every small papillary tumor does not require removal when observed. Some of these tumors grow very slowly and, with proper reassurance, can be safely monitored. "Mark Soloway; Miami; Urologic Oncology: Seminars and Original Investigations Volume 24, Issue 1 , January-February 2006, Pages 58-61

Watchful Waiting Policy in Recurrent Ta G1 Bladder Tumors - Conclusions: Small, recurrent papillary bladder tumors after resection of low-grade Ta tumor(s) pose minimal risk for the patient. A watchful waiting policy— without resection of the tumor—may be considered in these patients Ofer N. Gofrit, et al.Israel; European Urology Volume 49, Issue 2 , February 2006, Pages 303-307 PubMed
http://blcwebcafe.org/superficialblca.asp

All the best to you.
Wendy

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13 years 3 months ago #538 by amy
Hi I am 26 years old and I was just diagnosed with low grade, non-invasive, tcc. I had a cysto in the office and an IVP (which showed dialation of my right ureter and kidney as a result of my recent pregnancy). The urologist said he will se me again in three months for a cysto in the office. He is not doing any other diagnostic tests. How does he know that the cancer did not get into my bloodstream and into my lymph system? How can the doctors be confident that the cancer is confined to the bladders innermost lining stage ta? Any reply is appreciated.

Thanks

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