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84 y. old male: radical cystecomy or not?
Hi,it is my first time posting on behalf of my father-in-law who was diagnosed now with invasive bladder cancer, after a few earlier procedures.
The only options are supposed to be a radical cystecomy or doing nothing. The doctor found high-grade invasive urothelial carcinoma, a tumor, along the left bladder neck and left lateral wall region extending to the bladder neck. The tumor invades the muscularis propria (detrusor muscles). I guess that means T2, Stage II.
His next two appointments are with the cardiologist, to see if his heart could take the surgery, and then with Dr. Mark Soloway, the surgeon in Miami about the surgery. He is in decent health, but not superfit. He stopped playing tennis about five years ago.
Does anyone know someone who, at about 84 years old, went through such an operation. What was the result of the operation, what was the recovery time and what was the quality of life?
With many thanks already, Daisy -
7 Replies
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Daisy…here’s that article i was talking about with invasive bladder cancer. I would show it to Dr. Soloway though i’m sure he’s aware of it…….worth a shot
http://www.urotoday.com/287/conference_coverage/maratona_urolgica_2009__bladder_cancer/maratona_urolgica_2009__management_of_muscle_invasive_disease__session_highlights08182009.htmlits free to register and read
pat -
Dear Harleygirl and Melodie,
Thank you for sharing your experiences. We will keep them in mind. On Thursday Dr. Soloway will go in to look at the tumors of my father-in-law, and then we’ll hear what he has to say.
Best, Daisy -
Daisey,
Sounds like you have one of the top doctors so I think your father-in-law has an advantage and moreso if he is fairly healthy.
My mother-in-law at age 80 had an RC, ten years ago. She was told by her doctor she could get a neo-bladder and so that is what she decided on…in my opinion that was a mistake. I think he misled her but then again, I wasn’t there at the appointment. Anyway, her heart stopped twice and the doctor had to stop after about 9 hours of surgery. They told her to go home to recover and to return and they would finish. But the surgery was so hard on her that she refused to return. She has been totally incontinent for the last ten years, wearing depends and having to change them every 2-3 hours around the clock. She would have been so much better off getting the bag.
Melodie, Indy Pouch, U.W.Medical Center, Seattle, Dr. Paul H. Lange & Jonathan L. Wright
Daisy, sorry to be posting on this matter so late but I have been out of the country for 3 weeks and am just now catching up on the forum.
My Dad had RC at the age of 80 (he is now 83). He was in relatively good health except for the bladder (and, it turns out prostate) cancers. He wasn’t big on exercising but he was in pretty good shape for his age. The day before his surgery he was up on the roof cleaning out the gutters!
He had complications with his surgery and had to go back into the hospital a second time the day after he was released and had to stay even longer the second time than for the original surgery. I think it was because we didn’t know to seek out a highly experienced surgeon who did this operation on a regular basis although what happened could have happened with any doctor perhaps.
Dad has the ileal conduit and pouch. He also has stents in both ureters which are changed about every 3-4 months. He gets UTIs from time to time. It was really tough going for him at first especially with getting his bowels to work again (an ileus was one of the complications he had.) Also, the surgeon did not remove Dad’s urethra and the cancer came back there so he had to have another surgery to remove that. He has been through a heck of a lot since being diagnosed. At one point, he questioned whether getting the surgery had been the right thing to do. I’m convinced it saved his life.
His surgery was in April of 2007 so we are approaching the 3-year mark soon. He has adjusted, I suppose, but he has never been the same, energy-wise, since the surgery. It seems as if he aged overnight. For the first time I can ever remember, he seems to act his age now.
We had to talk to a few doctors before we could find one who would operate on a man Dad’s age, but they are out there. Maybe you should get a second opinion.
Best of luck to you and your father-in-law.
Daisy..here is one report of radiotherapy alone..no chemo..thats a tough one also..
http://cat.inist.fr/?aModele=afficheN&cpsidt=14010121
pat
Just wanted to let you know that Dr. Soloway thought that my 84-year old father-in-law would be to old to go through a radical cystecomy. He will now go in in early April to look at the tumors himself, and then decide on a chemo/radiation approach. So let’s see.
Thanks, DaisyHi Daisy…..
well to begin with your father in law has one of the top uro/surgeons in the country in bladder cancer and i’m sure he will take everything into consideration. Here’s a paper written in 2009
http://tinyurl.com/yhndl7y
Having said that ..and if only now i could find the paper..the italians have come up with going in and completely resecting the tumor even at T2…and they have found that it may indeed come back but at a lower stage and grade and they then use the usual BCG or Mitomycin C. I shall see where i posted it…
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