So she had her TURB yesterday and I think it went well. I really don't for the Urologist but maybe I'm just being overly sensitive. I'm not sure.
Originally she was told that there were two tumors seen on cystoscopy and the CT scan seemed to confirm that, showing two "tumors." When I spoke with the doctor yesterday he said that one of the spots had to be a fold in the bladder because he was only able to find one main tumor. I think that's strange, but he doesn't like anyone asking questions. Her original doctor said she saw two "spots" and the CT scan showed two "spots" but I guess it's just one now.
Anyways, he said the tumor was twice as large as he expected, about two inches in diameter. He said because of the size he had to go very deep into the lining of the bladder and she was catheterized as a result (one week with a bag). I'm unclear as to the protocol with lining involvement, but when we asked him if that was worse than just superficial, he didn't give a real answer. He gave me that look again. He then said there was this thing called BCG, but that was optional and it was just "bacteria that you flush the bladder with." Has anyone with a large (or I assume large) and lining involvement needed BCG?
He said there were several satellite areas of what he believes are cancer surrounding the main tumor which he cauterized.
The tumor was very close to the left ureter and I got the impression that he wasn't able to get as much of a margin there because of its proximity. I'm not sure what this will mean later on down the road.
A confusing aspect of the discussion was on grading. When her gyno found the cancer originally they biopsied it and it came back as low grade. Yesterday however, the urologist told us that the tumor was being sent to pathology to determine its grade. He said treatment would depend on whether it was low-grade or high-grade. When I asked him about the initial biopsy that showed low-grade, he either didn't remember that or he kind of made us feel like this could change now that the body of the tumor was available to view under a microscope.
He said she'd likely had this cancer for many years for it to have grown to this size.
I guess my concern at this point is if biopsies often differ in results from larger samples. How likely is it that the biospy said low-grade and this pathology will come back as high-grade?
He said he didn't see involvement of the muscle but that bladder cancer was a microscopic disease and only the pathologist could tell for sure. One week to get results seems like an eternity.
My mother's concern is that if this has been growing for years, how likely is it that cells have spread throughout her body? When I asked the urologist about this he gave me this quizzical look like I was the dumbest person ever and said "This is a very, very common disease. I see it every day. Think of it like a skin cancer. You just check it and remove new spots as they appear." I didn't think this fully addressed my mother's concern about the possibility that this disease could spread or already have spread at a microscopic level. So he didn't actually answer my question. Are there any statistics about bladder cancer and metastasis?
What about tumor size? Is this a large tumor or is finding it at 2" common?
I know I'm throwing a ton of questions out but she is so very worried and we are too and it's so hard to wrap our heads around the word cancer without fearing the worst. I think if it hadn't been for her father dying after being told he needed no further treatment other than excision, it wouldn't be weighing on our minds, but how is it possible that these cells just hang out at their original site indefinitely?
Sorry for the length, I'm just so emotional and exhausted.