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96 yr old w/muscle invasive bladder cancer
My 96 year old father in law was diagnosed in January 2019 w/ muscle invasive bladder cancer and decided on no treatment. He subsequently agreed to radiation but only had 2 treatments. He had another cystoscopy 3 months ago that showed bladder cancer in situ. Another cysto was done this week and today biopsy results show muscle invasive bladder cancer. Surgery is not an option for his age and chemo would likely be fatal for him so his urologist is saying that he could possibly have immunotherapy. Any thoughts on this?
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10 Replies
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I was wondering what ended up being course of action with your 96 year father- in -law? My dad has had 4.5 weeks of radiation and so worn down and now edema in calves. He will continue with immunotherapy but his bladder needs a break, He did have second turb with good kind doc, I think bleeding has stopped but radiation very uncomfortable. Fears he will have an accident
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I kinda hopped on the earlier 96 year old dad, but yes mine is 93- and I guess starting some form of immunotherapy this week with oncologist after leaving not so great urologist and prior to meeting new one (couldn’t schedule for a bit) May be some part of tumor left… He has issues…I am shoved out of things till an emergency- so thanks for the pat on the back! Just trying to help them!!
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Sounds like your Dad is doing well for 96 and has good quality of life! Heck, he handled one TURB ok so maybe that will work if he needs another peek and the BCG…. you can always try and start and quit if it causes problems. Is there some tumor left? Pat yourself on the back as a good caregiver!
DX 5/6/2008 TAG3 papillary tumor .5 CM in size. 2 TURBS followed by 6 instillations of BCG weekly with a second round of 6 after a 6 week wait. -
Yes- well he can work out of a smaller hospital (where my dad had first resection) but not the bigger health care system he used to be a part of nearby! Exactly my questions!
The prob is the retention and blood loss- hence uro says cancer still an issue… And I do not have the report – this is the part of the hvign very sharp stubborn older parents- I am working on this!! -
I am a little confused by your narrative. There is no evidence of cancer and yet the urologist wants to respect “more of the tumor?” And then he would prescribe BCG.? What did the pathology report say
after the first TURB? Was the tumor low grade or high grade?Because the current urologist does not have hospital privileges, it is difficult to see how he is going to do further resection.
if he is getting a second opinion, I would want to wait until after that before additional treatment.
Sara Anne
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator -
Follow-up: So my dad did have a PET scan ordered by a wonderful oncologist after tumor removal and it was perfect! No cancer anywhere- even bladder–He continues to have urinary issues thru holiday (blood, retention) and finally went back to his urologist ( who we frankly feel is very outdated and is no longer part of the local medical systems or has local hospital privilege- but my almost 93 year old father has a bond with him. He treated him for a UTI which made all kinds of sense as his manor was very off, and I don’t think UTIS are recognized enough.. but he then said he should go back in and resect more of tumor he removed in fall and then see my dad in his office where he would insert medicine into his bladder once a week for six weeks.. I said “BCG?” and he was stunned I knew that.
Anyway. Dad has agreed to get a second opinion with a hospital based practice. I was surprised to learn that he he starting immunotherapy this week before he can get an appt with new urologist. Does he not need further surgery? But he has obviously spoken to oncologist who said he would share info with new doc… Fingers crossed all goes well. My 9o year old mother is accompanying so she can understand whats up. -
Does the hospital provide psyco-concology service to cancer patients?
Psyco-oncologist is psychologist specializing in cancer and cancer patients.A while ago, I watched a video interview by a psyco-oncologist (sorry I cannot find it now). One of his case
was a female patient who did not want to have a chemotherapy. The psyco-oncologist evaluated
the patient and determined the the patient had depression. So, he prescribed anti-depression
drug. Sometime later, the patient came back told the psyco-oncologist that she was going to
have the chemotherapy in rather up-beat mood. -
This is very difficult. If your father is mentally competent this is his decision. I hope that he has discussed this carefully with his doctors to be sure that he understands exactly what the treatment would entail so that his decision would be an educated one.
Your role is to support and love him no matter what his decision!
Sara Anne
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator -
my 92 year old father was presented with this option. He has aggressive invasive bladder cancer. He is reluctant to go for regular infusions and very worried what a PET scan would reveal. Which he would have to do regularly. He just is tired and not into any of this . It’s hard. I understand where he is coming from.
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So sorry to hear about your father-in-law. Immunotherapy, most notably Ketruda, does appear to be relatively more tolerable than chemo and has been effective in some cases.
Sara Anne
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator
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