I am a 34 year old male recently diagnosed with bladder cancer. I have looked around here since I was diagnosed, but this is my first post. I had surgery on November 30th and the tumor was removed. Yesterday was my first of six BCG treatments, and I got a copy of my pathology report. I have some questions regarding the pathology report I am hoping someone can answer. Here are the details of the report:
- 5-gm, 3-cm tumor
- Tumor Histologic type: Invasive urothelial carcinoma
- Histologic grade: High grade (ISUP/WHO system)
- Primary Tumor Stage: pT1 (tumor invades subepithelial connective tissue)
- Muscularis propra: Present
- Additional Findings: None
From the report, am I correct in stating that my tumor/cancer is T1G3. If this is not right, please correct me.
Being just 34 years old with a 3 year old daughter, I am a little freaked out. Mostly because I do not know what to expect. My doctor has directed me to have a series of 6 BCG treatments, followed by exams and maintenance treatments. The maintenance treatments are in series of 3, and supposed to occur quarterly. From what I have read my doctor is treating this accordingly, but I cannot seem to get a feel from him about how bad this is. I sometimes feels he is beating around the bush instead of just laying it out there for me. Sorry this got so long and I strayed from my original subjext, I am just trying to put what I have in perspective.
I think you are correct in your T1 G3 analysis of your Path report. That is what I am reading also. I hope if we are wrong that someone who knows more will correct us, but I feel pretty comfortable with this analysis. Your Path looks pretty much like mine.
First off, if the tumor had invaded the muscle tissue then the Uro would not be treating you with BCG's.
It LOOKS to me like you had a SINGLE tumor, which generally has a better prognostic outcome than multiple tumors. I do say generally....I had multiple tumors yet have not had a recurrance in over two years. Not having early recurrance is also a prognostic indicator. Nothing with this disease, however, is set in stone.
I am just guessing that because you had a single tumor that this is the reason that your Uro did not do a Re Turb soon after the initial TURB.
Please just remember that you always have the option of a second opinion concerning your pathology report and for any further biopsies.
From what I can tell so far, your Uro is right on track.
Stay on top of it.
Age - 55
T1 G3 - Tumor free 2 yrs 3 months
Dx January 2006
Thank you for your reply. Yes, it was a single tumor that was removed, and he said he got it all and there were no more. What confuses me in the pathology report is Muscularis propra: Present. He said it got into some muscle. This is where he gets vague.
It has me thinking that he is trying BCG because I am so young, and hoping that re-occurance will be prevented. But end the end it is a futile effort. I know I am in a wait and see situation right now, and that makes it so much harder for me. When I go for my treatment next week I am going to press for more information. Thanks again for your reply and best of luck.
I think I just figured out what Muscularis propra: Present means. I think it means there was muscle tissue present with the tumor submitted for the pathology. This helps them tell if they got all of the tumor. If this was reported as not present, there would be some of the tumor left in the bladder. If this is not correct, please someone tell me.
This site has really helped me get a better handle on things. Thank you to all who have posted their experiences.
Your path report clearly states T1, so your analysis that it is T1G3 is correct. The fact that muscularis propria was present is crucial. If there wasn't any muscle in the specimen, the pathologist could not conclude that it did NOT invade the muscle. That means the specimen was adequate and your stage is correct.
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