Father diagnosed with high grade urothelial carcin

7 years 3 weeks ago #46366 by dinwal
Hey guys,

I need a recommendation on where to get a second opinion. My father was diagnosed with a malignant tumor in his urinary bladder in February 2014 so the doctor suggested removing the tumor by TURBT. We did it and after that he underwent 6 doses of mitomycin C (1 a week).

He never felt better, always complained of spasmodic pain. During the quarterly cystoscopy he was diagnosed with a recurrence of the tumor. This time we got it removed using Holmium laser. He feels perfect but the histopathology report says he has high grade urothelial cacinoma with glandular differentiated inflitrating the lamina propria and smooth muscle bundle. We sent the slides/blocks for second opinion at another lab and the results still said high grade utothelial carcinoma with glandular differentiation. The tumor invades the periurethral stroma. The adjacent urothelial mucosa shows carcinoma in-situ.

His deep biopsy shows uninvolved smooth muscle.

Now the doctor advises removal of bladder. Entire treatment so far took place in India. I want to get a second opinion from a doctor in US. Most of the clinics in US ask us to fly my dad here for a second opinion, they won't meet me to discuss the treatment plan. University of Chicago medical center said I could send the documents in for second opinion. I am not sure if that is the best way to do it. I am in Chicago for two more days if you guys know a clinic where I can discuss this in person.

Is that the best way to get this done or do you recommend any other place for me to send the records? Is there any other option for us? I appreciate any help on this. Thank you for this awesome community and the support people get here.

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7 years 3 weeks ago #46367 by sara.anne
Welcome to the Forum! We are sorry that you and your father are facing this problem.

With a diagnosis such as his, removal of the bladder is probably the best option. Bladder cancer is very "sneaky" and can come back again and again.

The University of Chicago has an excellent reputation for the treatment of bladder cancer and would be a good place to seek advice. I believe that Johns-Hopkins in Baltimore, MD, may also do a review of medical records.

Will be thinking good thoughts for you.

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator
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7 years 2 weeks ago #46388 by dinwal
Thank you Sara. I am going to send the documents to UC Hospital.

My father feels completely healthy now. Also, his deep biopsy was clean. Is there any possibility that the cancer has not spread? Is there any tests that could be performed to know for sure if he still has it or not?

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7 years 2 weeks ago - 7 years 2 weeks ago #46389 by Alan
A second TURB (surgery to take a biopsy) is often done to verify the first diagnosis. Almost a standard procedure America. With your first TURB showing muscle involvement you want to have this done quickly because of possible progression and unfortunately, cystectomy is the recommendation when that happens. Chicago should be wonderful for a second reading. There are many survivors on this board that have gone through this. I am one of the fortunate that haven't but, I am still vigilant with my checkups.

Also, a CT scan is often done to check the kidneys and ureters for any other involvement.

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.

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