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size of tumor
My recent pathology report stated ….high grade papillary urotheleal carcinoma…….laminar invasion cannot be excluded with certainty……flat urotheleal carcinoma in-site…..follicular cystitis…….muscular is propaganda not present for evaluation……0.4 times 0.4 times 0.3 cm. I am to start BCG in 3 weeks……This is my third experience with bladder cancer ,the last being a small spot 5 years ago that was removed with no following treatments ,just follow ups. I am a 76 yr. old female. I’m don’t completely understand the report or the size of the tumor. I am a little anxious about this report and would appreciate any or all feedback. l receive all my medical attention at the Cleveland Clinic which is number 2 in Urology.
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11 Replies
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Thank you I will ask my nurse about it at the next treatment.,but feel relieved hearing about it from someone who’s already inquired about it since you’ve been through it . It is so good to have somewhere to go to ask questions of those who’ve had the same experiences. I will sleep well tonight . Thanks again.
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I had the same question about the pneumonia vaccine. My doctor said it was fine to have both the pneumonia and the flu. I only had the pneumonia vaccine since they were out of the flu vaccine during my last BCG treatments. I didn’t have any problems.
I saw this from a 2011 BCAN post: Hopefully this will make you feel better about it.
“Just had to reply to this one, as I also questioned the advice of having a flu shot (had 2nd out of 6-BCG) I emailed Dr. Lamm and got an A-OK reply from him. I asked my BCG nurse at U of M hospital in Ann Arbor and was told, “as long as it was two days before instillation of BCG”, reason being if one had a reaction, Dr’s would know what to treat…BCG or flu shot. I also mailed Jack on BCAN, and his reply was he’d had at least three while on BCG with no problem.” -
I would think it might be the other way around….But have never heard this one myself. Probably best to ask your doctor.
Sara Anne
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator
Well I had my first BCG treatment last Friday and it all went very well. I had no side effects but I am concerned about something I read yesterday. I had a flu shot three weeks ago and I read that BCG treatments should not be given until six weeks after a flu shot but it didn’t say why. Now I’m worried that the treatment isn’t working because it was so soon after the flu shot. Does anyone have any information about this?
It was my pleasure Sylvia. You are correct that BCG is normally for high grade Ta and T1 staged bladder cancer, but it can be used for T2 as well although with T2, my urologist told me that cystectomy is more likely to be recommended. But it also depends upon whether the cancer is single focus (i.e. one place only) or multi-focal (many places – indicating that the entire bladder is a ticking time bomb).
Again, good luck to you and I will indeed report my experience next week.
T1 high grade transcell diagnosed 8/14/2015
TURBT 8/21/2015, removed tumor (17mmX14mmX11mm)
Repeat TURBT performed 9/25/2015
Pathology Report: no residual cancer detected
BCG planned starting in October
Thank you Engineer. After reviewing biopsy report again, I realized that the size of the tumor was not included. The cm. were the biopsy samples sent for testing. DUH. I do so thank you for making the report clearer to me. I’ll have to ask my urologist why he didn’t do a second TURBT before ordering BCG. ( I’m not anxious to do so). It is my understanding that BCG would not be helpful if there were muscle involvement. I would very much like to hear how you are doing with your treatments and will do the same. Best of luck to you also.
Sara Anne Thank you for the advice. I’ll have my daughter drive me for the first time. She will glad to do it for me. I will take plenty of old towels ! I feel less anxious already. I am so grateful to have found this forum. It helps to know your not alone and others can help by sharing their stories.
Sylvia – you should definitely ask your urologist to interpret this with certainty, but for what it is worth, it sounds like your tumor was 4 millimeters by 4 millimeters by 3 millimeters in size; by contrast, mine was 17 X 14 X 11, much larger by volume. The report suggests that they can’t rule out invasion of the lamina propria which is the layer of the bladder right below the epithelia cells; invasion of the lamina propria would stage your cancer as T1, no invasion means superficial Ta. The fact that there was no muscle tissue present indicates that the urologist did not “dig deep enough” to get any; that is what happened to me as well on my first TURBT. Second TURBT he “dug deeper” and got muscle tissue so that the pathologist could look for evidence of cancer cells in that tissue – which would make the staging T2.
Bottom line is that as Sara Anne said, BCG is exactly the right treatment here since you have CIS and high grade. Needless to say, best of luck to you; I also start BCG next week, we can compare notes.
T1 high grade transcell diagnosed 8/14/2015
TURBT 8/21/2015, removed tumor (17mmX14mmX11mm)
Repeat TURBT performed 9/25/2015
Pathology Report: no residual cancer detected
BCG planned starting in October
Sylvia, everyone responds/reacts to BCG somewhat differently. I went by myself to the urologist’s office for the instillations and drove myself home….about 1/2 hour. You might want someone to go with you the first time until you are familiar with the “feeling.” I know that they want you to hold it for two hours if you can….I always made it at least to 1 hour and 45 minutes!! Have not had experience with the interferon. I would take a pile of old towels just in case.
You can wash them with bleach…not so the car seat.Sara Anne
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator
Thank you for your response Sara Anne…..I forgot to mention that I will also be getting interferon in my treatments. Will I get sick from the treatments? Do l need a driver to take me? I am an hour away from the hospital.
Not being a pathologist, I really cannot interpret the size part of the path report. I suspect that it is descriptive of the size of the sample, but don’t really know.
The “take-home” from this is clear, however. The diagnosis was “high grade papillary” and CIS. The treatment plan is right-on…..BCG is most effective in high grade tumors and with CIS….which is also a high grade form of urotheleal
cancer.You have discovered the dirty little secret of bladder cancer….it tends to return. You are in an excellent place for treatment, and, the type you have is very often readily treated with BCG.
Good luck to you.
Sara Anne
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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