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from italy - please give me your suggestions

9 years 3 weeks ago #39483 by scarpa
As for San Raffaele I forgot to say that they have big budget problem and perhaps will go for a failure so I image they will have big troubles in the near future.

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9 years 3 weeks ago #39482 by scarpa
Thank you both for your help.
Yesterday my father told me he will go for a second TURB. I still wait for your suggestions, if you have, for Italian best experts for bladder cancer.
you have been really kind with me and your support has been vital.
I am thinking about this thing all day and also all night long.
Only my little son (1 year old) can divert my attention from my father's illness.
I am sole daughter and I must be the one who sustains with the smile my father and my mother but it not easy.
my relationship with my father is so strong that I cannot describe because exactly ten years ago I risked to lose him in a terrible road crash. It is really a miracle that he is still alive.

However thank you again for your help and all the best to you.
I hope I can do something for you.
Elisa

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9 years 3 weeks ago #39480 by sara.anne
Elisa, you are fortunate to have choices in where the care is received. I have/had CIS, and have done the BCG. There are two separate issues here...one is to be sure that the TURB was thorough and that the cancer has not developed into the muscle. This is why so many recommend a second TURB several weeks after the first. In my case, the CIS was not confirmed until the 2nd. BUT my urologist knew some areas of the bladder looked somewhat suspicious and was able to concentrate on them the 2nd time.

You are correct that you don't want to wait a long time for the BCG, but you DO have time for a second TURB, if that seems advisable, AND your doctor will want to wait until the bladder is COMPLETELY HEALED from the TURB before starting BCG. Any open wound in the bladder would allow the BCG (which is a live bacteria) to get into the rest of the body and that is NOT a good result.

Best of luck to you and your father. He is lucky to have you by his side.

Sara Anne

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

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9 years 4 weeks ago #39474 by Patricia
Wish i knew more about Milan. I will ask my surgeon at USC/Norris if he has a recommendation and get back to you. I did notice a San Raffaele Hospital in Milan that had a experienced urological team..a Dr. Cestari. Its difficult for me to translate the other way around. Terrible since i'm Italian but only took a crash course in it about 25 yrs ago. Can read most of it but can't write it.
pat

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9 years 4 weeks ago #39469 by scarpa
Thank you very much Pat for your help.
I cannot understand one thing: do you mean IEO is the correct place or not?
perhaps can I contact some USA bladder cancer experts who can suggest me where to go in Italy? what do you think about?
Thank you again.
Elisa

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9 years 4 weeks ago - 9 years 4 weeks ago #39466 by Patricia
Elisa,
Here is a great paper written on the European Guidelines for a second TURB....its also what we recommend in the states.
http://www.europeanurology.com/article/S0302-2838(10)00367-2/fulltext
As for IEO its a bit confusing as the urologists listed are from USC/Norris...in Los Angeles...Drs. Skinner and Boyd..very well known uro/surgeons in the bladder cancer field.
You want someone who sees a lot of bladder cancer...its an elusive and not very well studied cancer....Most urologists concentrate on the Prostate or other problems. CIS is considered high grade and often BCG will eliminate it...but if it comes back you want to make sure you are with a very experienced surgeon who really knows what he is doing.
Generally the wait is around 3 to 4 weeks after TURB..enough time for the bladder to heal from the TURB before BCG is administered. Dr. Lamm pioneered the protocol for BCG
http://www.blcwebcafe.org/drlammsprotocol.asp

pat

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