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Choosing Radical Cystectomy

2 months 1 week ago - 2 months 1 week ago #58772 by Alan
Welcome gqkandrk,

Sorry for the reason to be here! You are doing all the right steps including the second opinion that should confirm and give peace of mind on what to do. I have not had to have a cystectomy but, hopefully someone that has skipped BCG will respond.

It does sound like you have ruled out BCG as your case showed multiple tumors and part of the ureter being invloved so I understand. Plus, you still have time to further analyze. I am copying a book mark many have saved with an excellent discussion of the different diversions. Just copy and paste into yur browser. One last comment. Most accept whatever they choose and be sure whoever does it, does many a year. Meaning a minimum of 25-35 a year and has been doing them a for a few years.

See: https://my.clevelandclinic.org/health/treatments/12546-urinary-reconstruction--diversion

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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2 months 1 week ago #58771 by gqkandrk
Less than two months since diagnosis. Two TURBT's. Many tumors on first. One closed entry to ureter where thickening was first observed on CAT scan for a gastro problem. Presence of tumors in bladder surprised me and the doctor performing the procedure. Cancer also found on second TURBT. I am 71 in fairly good health.
Local doctor suggested third TURBT followed by course of BCG and welcomed my seeking a second opinion with the chief of urology at a major teaching hospital in our area.
Second doctor stressed that my disease was aggressive in nature. Found the course of treatment suggested locally to be a viable one but was also supportive of skipping directly to bladder removal. I have chosen the latter step and am riddled with self-doubt. I am conservative in nature but both doctors noted that the risk of my having to eventually have my bladder removed was much higher than in others with non-invasive cancer.
I know that no case is exactly the same but I just wanted to hear from others who may have skipped the BCG in favor of the radical cystectomy.
Many thanks for your attention to my concerns.

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