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cytology positive
Hi everyone,
Please forgive me if this has been discussed. Right now I am in panic mode and can’t look through everything. My 92 year old dad has had blood in his urine. He had a urine test (cytology) come back positive. He is scheduled for a cystocopy on feb 4. The doctor told me the positive result suggests a possible mass in the bladder. From what I had read on google (big mistake), if the cytology only shows positive if it is agressive and large. Is this true? Is there a possibilty it could not be cancer?
Don’t really know what I’m looking for other than something positive to look for.
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18 Replies
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I concur with Sara Anne. Especially with a 92 year old. Call on Friday so you avoid the weekend.
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.
If you have any doubts at all about whether you should call the doctor or not call. Also tomorrow is Friday and in my experience problems always arise on the weekend when you can’t reach the doctor so I would suggest you call tomorrow and discuss this with his nurse.
Sara Anne
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator
So dad has his turbt 2 days ago. He ended up having to stay overnight because of the bleeding. He will have a catheter in for a week (hopefully not longer). This brings me to my question….The doctor and nurses tell you to call if you have a lot of clots in the urine coming out into the bag. What are “a lot” of clots. He does have some and he has pain when the urine is coming out. We don’t know what is normal and what isn’t.
For most of us it was a day or two recuperation at home. I was lucky, my tumor was small and I was at work the next day (done early the previous day). You mentioned AFIB, and that is what may encourage a night stay. Jack suggestion may also work with a spinal. Just keep all your docs in the loop…and most of the time they do communicate with each other.
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.
Thank you for your comment. His cardiologist is being included in this as he is on blood thinners, Eliquis to be exact which is for prevention of stroke due to AFIB. We have not heard from either doctor yet as to the course of action to take regarding the surgery. It’s good to know that there are alternatives. I am finding out more information from this forum then I did from the urologist. I don’t have a lot of faith in doctors (sorry if I offend anyone) due to past experiences.
The urologist made it sound as if its not a big deal…”you go in and out the same day, we remove the tumors.” On one hand it made us feel that its very easy and “not a big deal”. On the other hand, I feel all surgeries are concerning, add the fact that you are removing probable cancerous tumors and add my dad’s age in there and it mulitiplies. My first concern is his coming through the surgery without any complications and his recovery from it. I have read that it takes 4-6 weeks for full recovery. What does that mean for a 92 year old? So many unknowns.
Sopranosgal,
Allow me add a comment – I noticed concern about anesthesia and age.
A spinal block can be generally be used instead of global sedation for a TURBT. Obviously the doctor would make an evaluation, but the stress on heart and lung function may be reduced considerably.
It is reasonable to include the primary care provider in the planning of a surgical procedure involving a senior.
Best
Jack
6/2015 HG Papillary & CIS
3 Years and 30 BCG/BCG+Inf
Tis CIS comes back.
BC clear as of 5/17 !
RCC found in my one & only kidney 10/17
Begin Chemo; Cisplatin and Gemzar
8/18 begin Chemo# 3
Begin year 4 with cis
2/19 Chemo #4
9/19 NED again :)
1/2020 CIS is back
Tried Keytruda, stopped by side effects
Workin on a new plan for 2021
Sorry to hear your Mom passed recently. That can explain part of your Dad’s mental state. Yes, they go through the penis. While it sounds barbaric it is much simpler than cutting through tissues that involve a much longer operation and recuperative time. As Sara Anne said they likely would hold him one night at this age and depending how quickly he would wake up. It really is mostly a non event for the majority with the risks factored in. How do they get the tumor out? Just a guess that it is pieced out whatever preserves the specimen for pathology the easiest and for the patient.
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.
Thank you for your imput Alan and Sara Anne. I am trying very hard not to influence his decision one way or another. He has gone through a lot in the past year with the passing of my mom. Although he is a “good” 92 year old, he has declined since her 8 months ago. I have a stupid question….when they go in to remove the tumors (turb ) I am assuming they go in through the penis? And if that is true, how do they get a 2″ tumor out of the penis? :ohmy:
First, I don’t think that you and your dad understand the situation with non-invasive transitional cell bladder cancer, which is the kind most of us are diagnosed with. IF it is low grade and early all that might need to be done would be removal of the tumors by TURB. If it turns out to be high grade, BCG would be a consideration.
Only if the cancer has spread (and you won’t know without the TURB) would traditional chemo even be considered. Radiation is not the treatment of choice for advanced bladder cancer in most cases. IF the cancer has spread (and your dad does not know this) that would be the time to consider whether treatments such as chemo are indicated for him.
I suspect that Alan agrees with me that NOT having a TURB is choosing discomfort and illness down the road that could be avoided. Yes, a TURB requires general anesthesia. However, it is usually a very minor procedure (which is not to guarantee that he might not have problems.) I much prefer it to dental appointments, but then I am dental-phobic (should mention that my late husband was an oral surgeon!)
IF it turns out to be worse than we expect, THAT is the time for the kinds of decisions your dad is considering. I realize that this IS a personal decision, but had to share and expand my thoughts. Won’t mention it again.
Best of luck to both you and your dad.
Sara Anne
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator
No decision (waiting) is a decision and not a good one. It could change the stage (potential for progression). As his cystoscopy shows 2 growths he needs to find the status of them. Yes, the TURB can be a bit more difficult for a 92 year old. Pre-op the way most set them up with EKG, blood work etc usually rule out most potential problems. I am not in his shoes so my comments are purely conjecture on what I would do at 92. That said, I would still do the TURB and at least know what I am dealing with and might even be the end of further treatments. If the pathology says low grade most of the time it is “waiting and watching”, just a monitoring via cystoscopies. High grade? That is usually BCG immunotherapy which is far more tolerable than chemo however, let’s cross that bridge IF it comes up. Radiation is usually not done.
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.
My dad is thinking of not having the tumors removed. He said if it is confirmed to be cancer he wouldn’t go for radiation/chemo treatment anyway. I’m wondering how bad it would be if he waited a few months to have the test done again?
Sopranosgirl,
I am just reinforcing Sara Anne’s comments as I have been traveling the past week. AS she said your Dad has good health for a 92 year old so he should do well on this procedure. You should know what you need in a short time. Let’s just hope for the best one day at a time. We are here to listen!
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.
Just one more comment The statistics would say that it’s most probable that your dad has noninvasive and probably low-grade bladder cancer . Removal of the tumors by TURB will give you a much better idea of what you are facing. That would be the time to address treatment vs no treatment.
Sara Anne
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator
Obviously the whole thing is upsetting. I’m very concerned about the whole procedure even though it is relatively minor. When You are dealing with a 92 year old man, even an otherwise healthy one, I wonder if it is better to just leave it. I know I’m crazy to think that way but God forbid it is an agressive cancer, I wouldn’t want him to treat it. Quality of life is important. I don’t know, my mind is all over the place so I can imagine what he is thinking. Thanks for your help and information.
What your dad’s doc is proposing is a TURB (transurethral resection of the bladder.) This is done under general anesthetic…often as an outpatient procedure. With your dad’s age it is likely that he may get to stay overnight. The urologist will remove as much of the growths as possible as well as some of the adjoining tissue and send these to the pathology lab for analysis. ONLY AFTER THE RESULTS FROM THE PATH LAB ARE BACK WILL HE KNOW EXACTLY WHAT THE DIAGNOSIS IS. With all his experience he will have a pretty good idea, but it will take the path report to determine if it is high or low grade or if it has spread into the adjacent tissue. These results will help define what, if any, treatment your father should receive. Your dad may have some residual discomfort for a few days, particularly if it is necessary for him to have a catheter.
This is a relatively minor procedure, as medical stuff goes, but your dad’s age is a factor. He should do well.
Sara Anne
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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