No biopsy required? Help me understand

6 years 5 months ago #54179 by sara.anne
Replied by sara.anne on topic No biopsy required? Help me understand
A biopsy is needed and that is what they’re going to do with the upcoming surgery. There is no way to do a biopsy except for this

Many urologists do not ask for a ct scan before cystoscopy since ct scan does involve a lot of radiation exposure. However it can show problems outside the bladder that cystoscopy cannot. During the cystoscopy the doctor is able to look directly at the tumor so that he is thoroughly prepared to do the biopsy. There is also a form of high grade bladder cancer that is more like a rash on the surface of the bladder than a solid tumor ( CIS) that would not show up on ct scan. If he sees areas of”irritation” he can pay special attention to them during the biopsy.From his experience he has a pretty good idea of what is there but will not be sure until the path report is back.

From your description it appears that everything that is being done for your father is exactly what should be done.

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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6 years 5 months ago - 6 years 5 months ago #54178 by Alan
Replied by Alan on topic No biopsy required? Help me understand
Welcome. The cystoscopy is always done to verify when a CT scan indicates a potential problem. Together they give you a better picture. They are the "gold standard". Plus, it will help the surgeon do his work better when he does the TURB.

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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6 years 5 months ago #54177 by Concernedformydad
Replied by Concernedformydad on topic No biopsy required? Help me understand
I have an additional question for you. Why do a cystoscopy to just look at the tumor that the CT scan already showed he had if a biopsy is not needed? The CT scan showed there was a tumor that needed removing, so why go in the bladder and look?

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6 years 5 months ago #54176 by Concernedformydad
Replied by Concernedformydad on topic No biopsy required? Help me understand
Thank you so much for explaining this to me. I was beginning to think that he was going to have to have an additional cystoscopy in order to get a biopsy before his first surgery. I'm so glad he will not have to! You have helped us more than you know!

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6 years 5 months ago #54174 by sara.anne
Replied by sara.anne on topic No biopsy required? Help me understand
The surgery that they will be doing to remove the tumor IS the biopsy procedure. It is called a TURB (transurethral resection of the bladder.) During this procedure, the tumor(s) will be removed and sent to a pathologist who will determine IF it is really bladder cancer, what kind it is (most are transitional cell carcinoma), whether it is low grade
(slowly growing) or high grade (rapidly growing) and whether or not it is still confined to the bladder lining. Sometimes, when it is low grade and localized this is the only procedure necessary. In other instances the results of the path report will indicate which direction the treatment will take.

ONLY AFTER THE PATH REPORT IS BACK will the urologist really know what the situation is. BTW, your father will want to ask for a copy of this report for his record. After the TURB the urologist will know a little better what he is dealing with, but not for absolute sure until he has the path report. Sometimes that path report indicates that there are areas of uncertainty and a second TURB will be scheduled.

Hope that this answers some of your questions.

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator
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6 years 5 months ago #54172 by Concernedformydad
No biopsy required? Help me understand was created by Concernedformydad
My dad was just diagnosed a couple of days ago with bladder cancer. He went to his primary care dr today for other reasons, but I had them ask him when we would hear back from the biopsy. The primary care dr said that no biopsy was done, that it would be done the day that the surgery to remove the tumor is done. Don't they need to know what type cancer he has before the surgery is performed? Was that the norm for you guys?

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