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diagnostic tests
Hi I am 26 years old and I was just diagnosed with low grade, non-invasive, tcc. I had a cysto in the office and an IVP (which showed dialation of my right ureter and kidney as a result of my recent pregnancy). The urologist said he will se me again in three months for a cysto in the office. He is not doing any other diagnostic tests. How does he know that the cancer did not get into my bloodstream and into my lymph system? How can the doctors be confident that the cancer is confined to the bladders innermost lining stage ta? Any reply is appreciated.
Thanks
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8 Replies
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Holly,
I was diagnosed in January with a very large tumour. I’ve had 3 biopsies. Each pathology report has had wide ranges of differences…from ho-hum, to panic, to nothing…I finally asked my good doctor (as we could not seem to get a solid read on the tissue) if pathology was subjective…and the answer was “Yes” it is subjective.
So these doctors are basically, I think, looking at your bladder tissue under a microscope and making an educated guess.I think that you would be wise to get a second opinion and I think you should just ask a lot of questions about this to your Doctor.
Rosemary
Age – 55
T1 G3 – Tumor free 2 yrs 3 months
Dx January 2006
Thank you for responding. No, I am not having any treatments. As a matter of fact, the urologist wasn’t even sure I needed the biopsy when he first told me about the cytology reports saying I had noninvasive papillary carcinoma. He thought maybe I could wait a month or two and recheck it, saying he’s seen this before and oftentimes it really isn’t anything to worry about. But I insisted on the biopsies immediately, which according to him, showed I have bladder dysplasia. His advice was to have another cystoscopy in 6 months. I have had the biopsy tissues sent on to another lab for a 2nd opinion though, and I’m still waiting for those results to come back.
So, you did NOT have cancer but are still having th BCGs? Did your doctor suggest that you have them or did you ask for them?
Holly,
I had the same results, in a way. The Dr’s were worried about having to take the bladder, and then when they finally got enough tissue to see if cancer were in the wall, presto, the cancer was gone…
I don’t even have the precancerous condition..but,I am doing the BCG’s though. Do I understand that you are not having the treatments?
Rosemary
Age – 55
T1 G3 – Tumor free 2 yrs 3 months
Dx January 2006
I had my bladder biopsy yesterday. My urolgist said he could find NO tumors anywhere and if there was cancer it would be microscopic and easily treatable. Then the results came in today and indicated no cancer but I do have dysplasia in a few spots according to the biopsies, which my doctor said is pre-cancerous so he wants to repeat the cystoscopy in 6 months. I understand that all of you are dealing with much worse, but I am just wondering something that maybe someone has an answer to. If my bladder wash from the cystoscopy showed noninvasive papillary carcinoma (studied by the Mayo Clinic) three weeks ago, how can the biopsies show NO cancer at all? Should I get a 2nd opinion?
Forgive me, I don’t know how to do this “posting stuff.” :) It’s new to me and I keep getting lost. I just posted under another question and then found this posting and it seems to be more of what I’m interested it.
If there is no tumor in my bladder and it turns out that non-invasive papillary carcinoma has originated in my ureter, what kind of treatment is generally done for that? How slow growing is this type of cancer, or in other words, how long can it grow before it would be considered dangerous? I guess I fear because the blood in my urine has been easily explained by the kidney stones I’ve passed monthly over the past year, yet I also felt there to be something else wrong and wonder if the cancer caused symptoms that no one (including myself) suspected were more than just stones. :(
Hi Amy,
Most of us with this type of cancer feel that way… we go a long time being told we have an infection etc, since the tests to check for cancer are so expensive and we don’t fit the profile. Being female and 47, my doctor didn’t suspect cancer the first time I had lots of blood, but I had it again 18 months later, and feel very lucky that she referred me to a urologist at that time, and he scheduled me for an immediate MRI and a cysto/TURB the next week. I had a very large tumor, but it was Ta, Grade 0 – and I am going for my six month follow-up next week. I guess if you are a male and over 60 and pee blood, they figure you for cancer first thing. But not for younger females. Especially as young as you.
I was also assured that this type of cancer would not have metastasized into the blood; yet I can’t help but wonder what is going on in my bladder for the last six months – did it grow back? 80% of the time, it does. Is it still non-invasive and low-grade? Sure hope so.
There is woman on this board who talks of 16 years and 37 TURBs… wow. Not something to look forward to, but she’s alive, she hasn’t lost her bladder, and she has a great outlook. Even my urologist said that if he was ever diagnosed with cancer, he would choose what we have over all other types. Hope you feel a little bit better, reading the stories on this board. 8-)
TaG1 12/05
3 recurrences
BCG started 9/09
Hi Wendy
Thanks for the reply. My post may have been a little misleading. The urologist saw the bladder tumor first on my IVP films. I had an IVP done two weeks after delivering my son. I had had blood in my urine throughout my pregnancy. The doctor’s office would not even mention the blood unless I asked whether or not there was blood in my urine. My GP ordered an IVP and referred me to a urologist with great hesatation. She thought I had post partum depression and felt I was worrying about nothing. The radiologist noticed a dialated right ureter and Kidney which are normal changes due to pregnancy. However, he failed to mention in the report the lesion in my bladder. MY GP called me to let me know the IVP was normal. She said I did not need to go to the urologist. Being that they had already referred me I took my IVP films a week later to the urologist. He looked at the films and saw the lesion. He was very concerned by my symptoms and the amout of UTI;s I had had during my pregnancy. He did a csyto that morning and told me about the superficial bladder cancer. 6 days later I had a TURB. Then he was able to give me a concrete diagnosis. He is planning on doing a UA and a csyto every three months for the next year. When I referred to test I meant CT scans or MRIs to confirm that the tumor had not spread. I spoke with the urologist this morning and he confirmed that this type of tumor at this stage could not have metastasized. I feel like if I had not been pregnant and having my urine checked for blood I would never have known I had the tumor. It really bothers me that the doctors would not even mention the blood until I asked. They would just reassure me that it was nothing serious. The only serious cause for hematuria would be cancer and I was too young for that! I am glad I listened to my instincts and my father who is a veternarian who did not think my IVP fils looked normal.
Hi,
I’m surprised to meet someone so young with TCC but there are more of you out there, I”m sorry to say.
Your diagnosis of superficial, non invasive TCC is a very common one, doctors are almost always able to diagnose this from the way it looks, though biopsies are done to confirm. Removal and no other treatment is more or less standard for a low grade papillary tumor. Because of the physiology of the bladder and its lining the cancer doesn’t enter the blood stream or lymph system unless it’s an aggressive, invasive sort of tumor. These are also easily diagnosed by the way they look but biopsies are needed to make a definite diagnosis with any cancer.
Do I understand you to be saying the doctor did not remove the visible tumor and do a biopsy and pathology? This would be an unusual move, but not without precedence, as recently updated on the main site:
Update 2006: Two articles support ‘watchful waiting instead of automatic removal of low grade superficial bladder tumors:
Expectant treatment of small, recurrent, low-grade, noninvasive tumors of the urinary bladder,..”As long as the tumors are low grade, the risk of invasion or metastasis is zero. Every small papillary tumor does not require removal when observed. Some of these tumors grow very slowly and, with proper reassurance, can be safely monitored. “Mark Soloway; Miami; Urologic Oncology: Seminars and Original Investigations Volume 24, Issue 1 , January-February 2006, Pages 58-61Watchful Waiting Policy in Recurrent Ta G1 Bladder Tumors – Conclusions: Small, recurrent papillary bladder tumors after resection of low-grade Ta tumor(s) pose minimal risk for the patient. A watchful waiting policy— without resection of the tumor—may be considered in these patients Ofer N. Gofrit, et al.Israel; European Urology Volume 49, Issue 2 , February 2006, Pages 303-307 PubMed
http://blcwebcafe.org/superficialblca.aspAll the best to you.
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