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My Doctor gave us good news after a second Tur
we are pleased but he didnt give us a grade or stage maybe there wasnt any, my first pathology report was bad it said I would need my bladder removed as the cancer was in the muscle wall,we have confidence in the last report as the surgen is very good, should I wonder about the stage and grade?thanks you all are so helpful
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22 Replies
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Sodapop , I too would be cautious, invasive then NOT?? Its conflicting, once it has invaded, its there, I wish I could just say great, but my recommendation is to have another opinion, be sure,,take care Ginger
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Dear Sod,
Thanks for keeping us posted. I am eagerly awaiting to hear what the oncologist has to say about this. I know you must be anxious….
Just remember that IF it comes to the point where the Doctor says the bladder has to go, that there are many here who have lived successfully, happily and cancer free beyond this point.
Good luck and waiting to hear…
Your Bud,
Rosemary
Rosemary
Age – 55
T1 G3 – Tumor free 2 yrs 3 months
Dx January 2006 -
Hi Rosemary, the second one says it was high grade invasive cancer, present in the muscle bundles but not the muscle wall,they just told us that yesterday. I have a call in to my oncologist to see if he has any answers for us.
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[quote author=sodacat link=topic=1763.msg13214#msg13214 date=1201919384]
on one hand I would like to go with good report and just be happy, but Id like to be more sure
[/quote]Please, please don’t just go with the good report. What Warren says is great advice–have your first turb results looked at by a bladder cancer specialist at a major cancer center.
There is no way to put a good spin on muscle-invasive bladder cancer, but believe me, you’ll be happier *knowing* your situation and all the ramifications and treatments options than you will be *hoping* your “good news” turb was the correct one. I–and everyone here–hope that the “good news” version is the right diagnosis, but make sure one way or the other.
“Standing on my Head”––my chemo journal
T3a Grade 4 N+M0
RC at USC/Norris June 23, 2006 by Dr. John Stein -
Hello,
I must agree with swilberstein. My first TURB show high grade into the deep muscle (stage 2). The 2nd TURB (done by a Univerity surgeon) found low grade and no high grade. 4 weeks later i had my RC/neobladder surgery. Pathology found it was thru the bladder wall. My point being – you need to be sure…
If it were me, I would get the slides to a major cancer center to be read. I would ask the following questions?
1. What grade
2. Does the specimen include margins and deep muscle? (My 1st TURB came back T2 only because they exhausted the material – no clean margins) This will help keep from understaging.
There are variants and types of bladder cancer that are more difficult to get accurate staging, as was mine. More than anything – you need accurate staging and grading to make smart choices.
God bless, Holly -
[quote author=sodacat link=topic=1763.msg13212#msg13212 date=1201913672]
no the second turb found no cancer in the muscle. The first lab that saw muscle invasive tumor was done with the specimen from the tumor of,my first turb. the conflicting report was done from a slide, could this fact effect the pathologists findings slide versis specimen? thank you sodacat
[/quote]Plain & Simple: We’re all glad you got good results from your second TURB BUT you MUST have the slides of your first TURB reviewed by a competent, indpendent pathologist. There’s too much confusion surrounding TWO TURBs. Untill you can be told unequivocally that the first TURB did not show muscle invasive disease the good results of the second TURB are irrelevant, even though it is good news. If the first TURB indeed shows muscle invasive disease, the current recommendation is to have your bladder out regardless of the results of the second TURB. Do not be distracted by the results of the second TURB. Pursue a review of the slides from the first TURB until you are 100% clear and confident regardng those findings. A first biopsy that shows muscle invasive disease (if it truly shows that by the interpretation of a competent pathologist) cannot be dismissed because of good results on a follow up TURB.
-Warren
TaG3 + CIS 12/2000. TURB + Mitomycin C (No BCG)
Urethral stricture, urethroplasty 10/2009
CIS 11/2010 treated with BCG. CIS 5/2012 treated with BCG/interferon
T1G3 1/2013. Radical Cystectomy 3/5/2013, No invasive cancer. CIS in right ureter.
Incontinent. AUS implant 2/2014. AUS explant 5/2014
Pediatrician -
Whew….well it really depends on what was on the slide. I know the slides i brought to MSK were not adequate for evaluation which is why i was scheduled for a second TURB to go back a resect the original tumor……do you know if the ORIGINAL tumor was resected? Pat
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Rosemary,we have not seen the conflicting report, although we have requested it today probably get it next week when the offices are open. we were told by the second surgen that he saw no cancer in the muscle wall. so thats where we stand on one hand I would like to go with good report and just be happy, but Id like to be more sure. thanks
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How is the second path worded? Does it say “No muscular proparis present”?
That’s how mine was worded……
Rosemary
Age – 55
T1 G3 – Tumor free 2 yrs 3 months
Dx January 2006 -
Rosemary, no the second turb found no cancer in the muscle. The first lab that saw muscle invasive tumor was done with the specimen from the tumor of,my first turb. the conflicting report was done from a slide, could this fact effect the pathologists findings slide versis specimen? thank you sodacat
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Does your second path say that there was muscle tissue present????
Rosemary
Age – 55
T1 G3 – Tumor free 2 yrs 3 months
Dx January 2006 -
Very confusing…….because initially you stated that there were multiple tumors and first doc did not get them all…but what he did get showed invasion. Second uro….may have removed different tumors that were not invasive…..what about the intitial tumor? I don’t know i would really question this. Is there enough of a specimen from the first TURB to send to someone like Johns Hopkins or MSK? Pat
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thank you all for sharing I had my latest path report e mailed to me today. it says the tumor is mainly low grade with a focus of high grade carcinoma5% and there is no muscle or lamina invasion.what do you think? thanks sodacat this is nothing like the first report in dec.
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Sod,
Your situation is a little bit similar to mine. I had a second TURB 6 weeks after the first. My stage and grade was upgraded at that time to T1 G3. However, this second pathology had the local pathologist baffled. According to the path report (in essence) it was determined that the results showed that the stage and grade COULD be good or it COULD be bad. (Something to do with “inversion” and “Brunn’s Nests”. The patholoigst sent the slides to the University Hospital in Chapel Hill and they determined that the results COULD be good or they COULD be bad, but they decided to favor the BAD opinion….
that’s the way it happened with me.
Send those slides to a good University Hospital….make sure that the 2nd specimen has plenty of muscle tissue.
Your Bud,
Rosemary
Rosemary
Age – 55
T1 G3 – Tumor free 2 yrs 3 months
Dx January 2006 -
Well this is interesting…as my initial TURB done locally showed muscle invasive disease…….got on a plane to Memorial Sloan and the infamous Dr. Herr who did a second TURB….got the remaining tissue and margins left behind by the first Uro and at that point since all was removed i no longer had any cancer cells in my bladder…however, since it was into the muscle it was still considered to be highly aggressive and the recommendation was to get the bladder out….it would be back.
I don’t know…i think i would want a doctor and pathologist not associated with the first doctor to view the slides. I mean i really really hope that it was not into the muscle and that you just had a poor uro and lousy pathologist….just be absolutely sure. Pat
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