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Newbie Here - When to Start Chemo

11 years 1 month ago #29267 by Patricia
maybe this will help
At any rate its always a good idea to have a second pathologist look at the slides.
personally when i took mine to MSK they took one look and tossed them and recommended a second TURB ...the samples were not good enough.
This looks like a simple case with a good prognosis but to be sure have the experts give a second opinion.

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11 years 1 month ago #29262 by sara.anne
Not sure if we really answered one of your important questions. "Low Potential" does NOT mean that it is not cancer. It is. It does mean that this type of tumor USUALLY does not progress rapidly.

I would second the recommendation that you seek a second opinion at a major cancer center. The situation that you describe does not always lead to a recommendation of immediate BCG treatment.

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator

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11 years 1 month ago #29261 by mmc
My opinion is to have the bladder cancer specialists (MD Anderson) confirm the diagnosis and recheck that pathology and give her a treatment recommendation.

If that treatment plan is BCG or even Mitomycin, then I'd suggest having the local urologist administer it so she could stay close to home.

MD Anderson could very well suggest a "watchful waiting" which is regular cystoscopic exams and TURBs.

I know some people on this site have been treated with BCG for low grade Ta tumors and others have not. I think that's based on the doctor that one sees. I think an MD Anderson specialist would probably be the best one to make that treatment plan recommendation (once they confirm diagnosis). They may even want to do a cysto and/or reTURB just to see for sure.


Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results....distant mets
2/2014 ct result...spread to liver, kidneys, and lymph...

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11 years 1 month ago #29260 by pemquid
From my understanding, the fact of having tumor recurrence, even though low-grade, could reasonably warrant starting on the BCG. I had a similar concern about the need for BCG, in that I had recurrence of only low-grade tumors, and that was after two years (not the short 6 months). However, my urologist recommended it, so I started BCG back in 2008, and am now on 6-month maintenance dosing.

And, based on my limited knowledge, the "PUNLMP" designation for tumors is not so common any more. If I had to guess, I'd suspect that the initial tumor and recurrence were both the same type, i.e. TA, grade 1 (at least as it sounds from the reports you've typed in).


Small TA Grade 1, May-06; recur (2 tiny), same, June-08; TURBTs both times. BCG begun July-08, dosage to 1/3rd May-10, completed treatment December-11. All clear since 2008.

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11 years 1 month ago #29257 by tlw
Pat: when it says "low malignant potential" does that mean it is not currently malignant and that the potential for becoming malignant is low or does it mean that it is malignant but not likely to grow into something much more serious (i.e., become invasive, matastasize, etc.)?

On the BCG issue, considering a tumor came back w/i 6 months (low grade or not) would that suggest that BCG might be appropriate?

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11 years 1 month ago - 11 years 1 month ago #29256 by Patricia
confusing.....PINLMP is of low malignant potential and almost always comes back the same. Usually its a wait and see situation.
BCG will not work on low grade bladder cancer...so i don't know why he's suggesting it. From Dr. Lamm

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