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Nervous Dad!

12 years 2 months ago #6951 by wendy
Hi Greg,
About the TURB issues, transuretheral resection of bladder, fulguration is pretty common to keep the resected tissue from bleeding. It doesn't ruin the specimen for pathology. So, your current plan of biopsy and fulguration sounds familiar to me, my sister had the same, she goes to Sloan, had a 3cm papillary tumor. She never received Mito, and most people with TaG1 tumors don't need it unless they continue to recur.

Your doctor is up on the latest guidelines but you still have the choice to not get the dose of mitomycin, see what the results are, see if you recur within the next year or two...my sister had the same grade and stage recur, never had any treatments aside from TUR, and they haven't recurred for thse past 7 yrs or so.

Lasered tumors will give you that situation where biopsies are wrecked, but that is reserved for people who have recurrent, low grade TA tumors that dont' need biopsies everytime they are removed.

Good luck, the fact it's so small and looks like an obvious papillary is a very good sign, all things being relative.

Wendy

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12 years 2 months ago #6950 by shaz
I will be getting a dose of Mitomycin with my procedure on Wednesday. Is that typical? I read some threads and there seems to be some controversy. Just wondering if I should ask my uro to skip that part. Thanks,

Gregg (shaz)

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12 years 2 months ago #6921 by wsilberstein

What's the difference between a TUR and a cysto with fulguration?

If I remember correctly, TURB stands for TransUrethral Resection & Biopsy... which is, of course, done through a cystoscope. If the tumor is fulgurated (burned) to remove it, there is nothing left to biopsy; however, if the electrocautery is used to remove the tumor and at the same time fulgurate the tissue underneath to stop bleeding, than a cysto with fulguration would be one method to do a TURB.

-Warren
TaG3 + CIS 12/2000. TURB + Mitomycin C (No BCG)
Urethral stricture, urethroplasty 10/2009
CIS 11/2010 treated with BCG. CIS 5/2012 treated with BCG/interferon
T1G3 1/2013. Radical Cystectomy 3/5/2013, No invasive cancer. CIS in right ureter.
Incontinent. AUS implant 2/2014. AUS explant...

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12 years 2 months ago #6911 by Rosie
Hi Rosemary, Patricia and Shaz,

There are urologists who take a biopsy and then fulgerate right in the office during the cystoscopy. Not many are equipped to do that but it sure saves the patient lots of time and money. I was in touch with a blc patient named Pat when on the ACOR email list whose urologist did it that way. She said it just felt like a "pinch" when he took a biospy sample. I have since been in touch with others whose doctors do that. All were in private practice and not under the guidelines or protocol of major cancer hospitlas. I have now found a urology group in Norfolk who can do procudures in the office right at cystscopy. I like that so much more than having to reschedule, go through pre-op, be put asleep to have a suspicious growth removed. All biospies, regardless of it being done in a hospital operating room setting or in the office are sent to pathology. It is more ideal if a cauterization or fulgeration is done after the TURB but it my case the fulgeration could not be done because of the location of the tumor and threat of scarring the area and closing off the opening to the left ureter orifice. Rosie

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12 years 2 months ago #6907 by shaz
Thanks Pat. A biopsy is inlcuded in my procedure next week.

Gregg

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12 years 2 months ago #6902 by Patricia
Well a cysto with fulgeration is just going in there and lasering out the tumor without taking a biopsy for pathology........A TUR is a resectioning of the tumor to send to pathology which is definately what you need to have done. It sounds to me like his plan is to do the TUR and then lasering it. He's assuming that the naked eye is reliable....
In my case since there was invasion into the muscle there was no fulgeration done.
Was that clear as mud? Pat

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