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Papillary Urothelial Carcinoma, High Grade bladder
I was just diagnosed with a High Grade Urothelial Carcinoma via a biopsy. The Pathologic Diagnosis reads as follows:
Papillary Urothelial Carcinoma, High grade
Negative for Lamina Propria Invasion
Muscularis Propria is represented and is uninvolved by tumor
Lymph-Vascular space invasion is not identifiedWhat does all this mean? How serious? What questions should I be asking ?
In 2007 I had prostrate cancer and prostrate was removed robotically. Does the prostrate cancer have anything to do with the bladder cancer?
Urologist has scheduled another biopsy. What am I looking at here. My Urologist is young (34) and I live in the Charlotte, NC area. Any suggestions on Urologists, treatment or anything else I may have forgotten to ask?
Any and all information very much welcomed. My family is very worried. Thank You wjjjcm
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7 Replies
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Thank you for the information. I had the 2nd TURB last Thursday and awaiting the report. The Dr told my wife that after the 2nd diagnosis he would consult with a cancer tumor board to discuss further treatment options.
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The prostate cancer probably doesn’t have anything to do with your bladder condition. These cancers arise from different cell types, specific to the organ involved.
And, as Alan pointed out, having a second TURB is pretty much state-of-the-art as far as diagnosis is concerned. The first time, the urologist took samples of what he saw and now he can go back and do more detailed analysis since he knows where the problem areas are. Bladder cancer, in the past, has often been seriously under-staged and this will help to be sure that the diagnosis is complete and accurate. Having a young doctor is really another bonus…they are more likely to be trained in the latest technology!!
With a diagnosis of high grade, you want to be sure to keep all your appointments so that the doctor can keep a close watch on this.
Sara Anne
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator
Thank you for your thoughtfulness. I thought having prostrate cancer was enough.
Thank you for the information. It is very helpful. I’m wondering if the prostrate cancer I had is connected to the bladder cancer? I really appreciate your assistance in this matter.
I am also just going off my research from my DX a year ago…but from what you wrote I would say you are Ta,G3 which is better than T1,G3. The tumor is on the surface of the bladder, (Ta), and hasn’t gotten into the middle layer, the Lamina Propria.
I had T1,G3 so they removed the tumor and then started the BCG treatments. Your doctor should go over this with you and pick out a treatment plan for you. Like I said, the fact that it is only on the surface is good news. The fact that it is high grade,(G3) will make it important to keep an eye on it more than a lesser grade.
Best of luck…
As Mark said, welcome but, sorry you “joined” our club. As I am not a doctor take it for whatever it is worth plus I don’t have my actual chart from my DX 4.5 years ago. However, your path report is VERY similar to mine. I had a papillary tumor (mushroom like), high grade. If I understand the terminology, it has not invaded your muscle which is good because otherwise you probably be into a different treatment protocol.
Read as much as you can from this web site about staging and grading. Grade 3 is high, 1 low and I am not sure 2 means much anymore (it was middle grade). Your doctor while young is doing what most on this board would recommend and is the standard of care which is a second TURB (transuretal re=section) to biopsy again. What they are looking for is to be sure the tumor hasn’t invaded the muscle (Stage 2). Stage 3 is deeper to the baldder edge and Stage 4 means it has spread. This is because many initial TURBs are understaged.
Size and number of tumors are also part of what you need to know.
Questions to ask your URO: how many bladder cancer patients does he see and treat each month. I would want to have him say at least 20+. Many, for obvious reasion treat far more prostate patients and with your prior DX of prostate cancer it makes you more at risk. Most would also tell you to get to a major bladder cancer center because of all above. Some that know more about the Carolina’s should have a good refernce point for a major bladder cancer hospital. It does sound like your young doctor is doing well-I’d just get the best you can because this is really best handled by a sub specialist.
I am 4.5 years post DX and been free from BC all that time. Read about BCG-which is immunotherapy and a normal treatment for my grade and stage TA(could have been T1G3). Meaning early DX and hasn’t hit the muscle but high grade.
Now you just need to ask more questions and wait for the results from the second TURB and hopefully more will chime in. There is lots of hope in beating this!
Besides this web site read: http://www.bcgoncology.com/cancer/ Dr. Lamm is considered one of the pioneering fathers in treatment. Also, a very kind & caring person!
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.
WJJJCM,
I am sorry to have to welcome you to the site. :dry:
I am not the best at grades and things. There are many others that are, and I am sure they will soon be on tryng to help you out.
In the mean time please use the search area and it will guide you to more information on your diagnosis.
Welcome- and hang on we will try to help .
Mark
Age 55
Diagnosed BC 12/20/2011 Ta No Mo 0a Non-Invasive At age 48
“Please don’t cry because it is over….. Smile because it happened!” {Dr. Seuss} :)Sign In to reply.