Path Rpt - Definitive Invasion is not identified

8 years 1 month ago #50746 by sara.anne
Replied by sara.anne on topic Path Rpt - Definitive Invasion is not identified
Usually just by cystoscopy. CIS looks like a rash or irritation on the surface of the bladder. As long as this is not present and seen by the urologist, everything is OK. If rash or severe redness appears, he would do a TURB to see if it was cancer.

One time my urologist saw a lot of redness/irritation. We discussed this and I agreed to let him take a small biopsy right then, without anesthesia. He agreed to be "gentle." It wasn't really pleasant, but was over fast. As he had suspected it turned out to be "BCG cystitis" or irritation from the BCG treatments. We both felt better that he had confirmed this. Waited two weeks until it healed and resumed BCG treatments.

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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8 years 1 month ago #50745 by Mike M
Sara Anne,

After BCG treatment, how is CIS confirmed as present or absent...cysto visual alone or cysto followed by TURBT biopsies?

12/15 - Diagnosed Ta HG, 1.5cm Pap, Focal CIS
3/16 - Began BCG following NCCN and SWOG guidelines
2/19 - Ta HG recurrence and CIS/Ta HG in right kidney/ureter
2/19 - Nephroureterectomy to remove right kidney/ureter
9/19 - BCGx33 completed
2/20 - Invasive HG urothelial pT2 in prostate stroma

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8 years 1 month ago #50717 by Jmitchell418
Replied by Jmitchell418 on topic Path Rpt - Definitive Invasion is not identified
Good luck Mike. Glad to see you're going the BCG route first!

45YO male
11/30/2015 Left nephrectomy
2/17/2016 left ureterectomy
8/10/2016 cyctoprostatectomy w/ileal conduit diversion
Cancer free since!
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8 years 1 month ago #50716 by Mike M
Your points are well taken Sara Anne. Treatment would remain the same for Ta/CIS and T1/CIS most likely. Interesting however that my Uro wanted to yank my bladder following a round of chemotherapy as his first recommended choice of treatment.

Begin BCG next week, so wish me luck!

Thanks!

12/15 - Diagnosed Ta HG, 1.5cm Pap, Focal CIS
3/16 - Began BCG following NCCN and SWOG guidelines
2/19 - Ta HG recurrence and CIS/Ta HG in right kidney/ureter
2/19 - Nephroureterectomy to remove right kidney/ureter
9/19 - BCGx33 completed
2/20 - Invasive HG urothelial pT2 in prostate stroma

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8 years 1 month ago #50715 by sara.anne
Replied by sara.anne on topic Path Rpt - Definitive Invasion is not identified
I really don't think it makes any difference at this point. What you do know is that it appears NOT to have spread into the muscle and lower layer, the with CIS present the proposed BCG treatment is exactly what you should expect either way.

Johns Hopkins University does do second opinions on pathology if that would make you more comfortable. You send the slides to them for review.

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator
The following user(s) said Thank You: Mike M

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8 years 1 month ago #50713 by Mike M
Hello Friends,
Had subject phrase in both pathology reports from my 1st and 2nd TURBT procedures, plus the phrase "the muscularity propria is present and not involved". However, my Uro still considers my cancer to be T1. Seems to me it should be Ta. What am I missing? Was wondering if anyone had the subject phrase in their pathology rpt and were diagnosed as T1 or Ta? Thoughts?

12/15 - Diagnosed Ta HG, 1.5cm Pap, Focal CIS
3/16 - Began BCG following NCCN and SWOG guidelines
2/19 - Ta HG recurrence and CIS/Ta HG in right kidney/ureter
2/19 - Nephroureterectomy to remove right kidney/ureter
9/19 - BCGx33 completed
2/20 - Invasive HG urothelial pT2 in prostate stroma

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