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A disparity in referring female patients to a uro
This is interesting as it is the Internist we need to target for advocacy and knowledge of blc.
Pat -
8 Replies
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Since bladder cancer is a disease of smoking men, why would you refer a woman to a urologist? Ha Ha …NOT!!
I was lucky..have told this before, but it bears repeating.
I went for my gyno check to a nurse practitioner at a women’s clinic. Mentioned having lots of UTI’s. She said immediately that if you have more than two UTI’s in a year you MUST go to a uro. I did and here I am. Never had any blood in my urine. Just HORRIBLE UTI symptoms. Both papillary TCC and CIS.
Uro said that the UTI symptoms are very typical of CIS.I sent a heartfelt thank you letter to the nurse practitioner for her quick referral.
Sara Anne
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator -
I have read about many women not getting the attention they needed quickly enough. When I had blood in my urine I was on my period at the time. I am so glad that I could differentiate between the two. Not so many women have been as lucky as I have that way. I was in the hospital emerg the next day.
Ta Grade 1
6 TURBS
15 BCG
dx Jan 07 -
It took 3 different doctors before I had tests done. I had know idea what was going on when I found gross hematuria. We were getting ready to move and going on vacation so the first Dr. I went to was at a clinic and he said I had a UTI. So off on vacation I go. 2nd Dr. in a town where I was visiting my sister. I was sick, achy, fever, gross hematuria…….treated for UTI. We got to the town we are in now and I go back in with same symptoms and he treats me for a UTI but does blood work but it shows everything is fine? I was due to go back in for a CT scan if blood was still there. I ended up in the ER room with severe pain in abdomen (due to severe endometriosis) CT scan found the large tumor on my kidney. So started the process of getting a Urologist. So I too wish that Dr.s would not just assume it’s a UTI or part of my monthly cycle that is causing the bleeding.
This was over a span of 3 months also. Ok that’s my story, lol. Didn’t mean to go on and on about it.Barb
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Interesting topic. I don’t know if I should post here because I had no hematuria. I did have pain and frequency issues, both of which continually increased. Because of my fibromyalgia both my Internist and I thought I had IC. I asked to be referred to a Uro. I was taking the pain meds for my fibro for the bladder pain and my Dr. knew it. She also knew I smoked. When the pain in my bladder became so bad that I needed stronger pain pills, I finally got my referral to a Uro – 6 wks later. Dr. did some tests for IC. 4 wks later looked in bladder. Saw cancer and schedued a TUR. Diagnosis, T1G3 and CIS. I had 6 weeks of BCG, then RC. If I had been referred when pain started, who knows what the diagnosis would have been. Couldn’t have been worse. Yes it is the Internist we need to target. Just because more men than women get BC, doesn’t mean that we don’t get it also. Kathy
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I agree that it is a deadly disparity. If I had not insisted on seeing a urologist my primary would have continued to treat me for non existent kidney stones. I had no pain just gross hematuria. The biopsy on my tumor is T3aN1.
Webs
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I agree with the need for quicker female uro referrals in general and for educating internists, but my own experience was (fortunately) quite different When I called my PC physician’s office about gross hematuria, I was taken in the same day, urinalysis was done, and testing set up right away (I think it was CT scan). I didn’t see my own doc, but another nice young woman doc who was available the day I came in. She told me quite frankly before any testing was done that hematuria in a woman was much more likely to be due to cancer, while men sometimes had hematuria for other reasons. As soon as the CT results were in, which showed a probable small growth of some sort, they got me in to the urologist within a week. After the cysto that confirmed the tumor, the uro was kind enough to schedule me quickly for surgery, as we had a graduation to go to, and right after that had tickets booked for a 2 week overseas trip. It probably helped that I’d had a hysterectomy some years before, so there was no way the bleeding could be attributed to anything other than the urinary tract. Because I had no pain at all, they could also be pretty sure it wasn’t any kind of kidney stones. (Interestingly, when they did the urinalysis at the first visit, a slight infection did show up, so they gave antibiotics, but nonethless proceeded with other testing and the uro referral as they were pretty sure the infection didn’t account for the degree of bleeding I had.) From the first bleeding episode to the tumor removal was under a month all told. And, it turned out to be a small, low grade, non-invasive tumor.
Small TA Grade 1, May-06; recur (2 tiny), same, June-08; TURBTs both times. BCG begun July-08, dosage to 1/3rd May-10, completed treatment December-11. All clear since 2008. -
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