Rosie et al,
I have this 'article' I (re)wrote, simplifying what Ta,G1 means, what do you think?
And Dan, you are right, T1 tumors and CIS are different and actually fall more into the 'invasive' category. But...do we need to separate even further on the forum?
Maybe I'll put this up as a reference for this category, and make one similar for CIS, multiple and T1-ers, for new forum members, what do you think?:
Papillary, low grade, low risk: stage Ta, grade 1)
Low grade papillary tumors are the most common of all bladder tumors, and make up about 80% of all diagnoses. Although they are sometimes referred to (incorrectly) as polyps-which are actually quite rare, these papillary tumors are actually a form of transitional cell carcinoma, or TCC. They are often referred to as “superficial” tumors because they do not penetrate beneath the inner lining of the bladder.
Papillary tumors are at low risk of progression to invasive cancer, but have a high risk of recurrence. Recurrences are almost always of the same tumor type. Conservative treatment with tumor removal (transurethral resection]) as the main treatment is acceptable. If no recurrence is seen follow up can be extended to yearly as opposed to every 3 months.
Sometimes recurrent, low grade Ta tumors can be fulgurated as an out-patient.
New investigations are suggesting that Ta, grade 1 papillary tumors do not necessarily need to be immediately removed every time they re-appear. The reasoning is that the repeated surgeries them cause’s wear and tear on the bladder, these tumors are slow growing and the threat of spread is virtually zero. The “watchful waiting” approach is beginning to catch on as doctors become more knowledgeable about the risks and benefits. Most people who become newly diagnosed with a bladder tumor could not imagine the idea of leaving it in….but some educated survivors are doing just that.
New guidelines in the field of intravesical chemotherapy are urging urologists to instill a chemo drug into the bladder immediately after removing the tumor. Some recommend it for Ta, grade 1 papillary tumors while others save this for tumors in a higher risk category such as “grade 2” or when there was more than one tumor found. This has been shown to delay the recurrences, with the benefit of treatment extending to about 2 yrs.
Not all doctors agree that this is needed for Ta, grade 1 papillary tumors who are newly diagnosed, and might not suggest this treatment approach unless there are numerous recurrences, or if the tumor recurrence shows more than one tumor on follow-up.
Wendy
Disclaimer: I am not a doctor, nor do I play one TV! The references for the above information can be found on the main site under the 'superficialblca' pages.
