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3 years 5 months ago #54427 by MM27
New to forum was created by MM27
Hi, I am new to this site and was hoping for guidance. My father most likely had bladder cancer. He is 63 years old, quit smoking 5 years ago after smoking 40 years. He began urinating blood 3 weeks ago. He went to his urologist. The urologist sent him for a cat scan which revealed a small 9mm x 5mm tumor. The urologist followed with a cystoscope a few days later. The drs report says that the tumor appears to be papillary. He is sending my father to the hospital at the end of the month to have another cystoscope to have the tumor removed and to biopsy it. He wants to follow with immunotherapy treatments. My question is should we stay with this urologist even though he is not a cancer specialist? We live in New York and I feel as though we should go to Sloan Kettering but I don’t know if that is jumping the gun. Should I wait for the initial biopsy before going to a cancer hospital? Is this something treated by a urologist?

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3 years 5 months ago - 3 years 5 months ago #54428 by Alan
Replied by Alan on topic New to forum
I was in you Dad's situation almost 10 years ago. I was lucky to have a local URO that while he might not have been a sub specialist in bladder cancer, he knew bladder cancer. I also had a small papillary tumor. He was about 50 and had studied under Dr.Lamm that many of us hold in high regard as one of the pioneers in treating bladder cancer. Check further on this site about these subjects including Dr. Lamm.

Reading your summary I say your Doc appears to be up to speed with this. The only question would be the immunotherapy. This is usually done with high grade tumors or re-occuring low grade tumors and without a pathology report you don't really know which direction to go. This you won't know until the TURB surgery (transurethral bladder resection) and path reports are done.. Do not be surprised if your URO does a second TURB to confirm good margins are done. This is almost always done on high grade tumors as they can be understaged.

After posting all of this, Sloan Kettering is an excellent option. If I had really understood what I was dealing with I would have gone to MD Anderson in Houston as I live about 3 hours from there. I was simply lucky with my guy. If your URO sees a lot of bladder cancer he is probably OK but, if you have doubts SK would be it.

Welcome and post as you go. Someone should be around with some "been there and done that".

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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3 years 5 months ago #54429 by sara.anne
Replied by sara.anne on topic New to forum
So sorry to hear about your father’s issues Bladder cancer is usually treated by urologists unless it has spread beyond the bladder lining . So far what you have reported is exactly what should happen . Your father will not really know what the exact diagnosis is until he receives a copy of the pathology report following the biopsy If indeed it is a papillary tumor and if it is still localized to the bladder lining and if it is low grade then it is likely that the urologist would recommend a “watchful waiting” with cystoscopy every three months If the tumor turns out to be high grade then immunotherapy would be indicated . This is not usually done with low-grade tumors because it is not as effective in those cases .

My suggestion would be to wait until your father has the results of his biopsy and the recommendations from the urologist as to how he might proceed . At that point he could make a decision as to whether the situation seems straightforward and he is happy with the recommendations or he could seek a second opinion at someplace like MSK. If there is any doubt as to the diagnosis for the treatment plan a second opinion would definitely be indicated .

Sara Anne

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