Very large tumor, cat scan did not show any spread

1 week 1 day ago #61125 by Chadni30305
Replied by Chadni30305 on topic Very large tumor, cat scan did not show any spread
Hi Waldo,

I am in Atlanta as well, i am thinking about seeing Dr. Narayan. Could you please let me know your experience with this doctor?

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1 year 6 days ago #60434 by joea73
I have not read or heard that size affects the severity ( survival rate). I know a fellow whose tumor was over 7cm when he was diagnosed. In his case, he had a kidney problem and an ultrasound accidentally discovered the tumor. He had decided to remove the bladder even it was not muscled invasive and he is doing fine.

In general, statistically speaking, the severity (survival rate) depends upon how deep cancer has progressed into the muscle tissue and beyond. Statistically speaking, the deeper cancer has progress, the survival rate becomes lower. But it also depends upon if it is metastasized or if lymph nodes are positive or not.

In terms of staging, if it is metastasized in other organs, it is classified as stage IV. If one lymph node is positive, it is at least stage III. If it has progressed beyond the muscle tissue and progressed to the fat tissue, it is stage IIIA or IIIB based upon how far it has progressed in the fat tissue. If it has progressed to the muscle tissue but not reached the fat tissue, it is classified as stage IIA or stage IIB. Below is the link to the document of how the stage is determined.

Usually, a urologist recommends the removal of the bladder if cancer has progressed the muscle tissue. Because of your father's and the complex surgery (4-6 hours) and the recovery process, the urologist will discuss also the treatment with preserving the bladder.

I am sure that many people in this forum can share their experience when you need to make a certain treatment decision. Also, it is noted that there are several new treatments developed for bladder cancers in recent years that were not even available five years ago.

Regards to 9 cm size, a hallmark of any cancer is that it keeps multiplying (dividing) 7x24 without stopping so the colony of cancer cells keeps growing. A healthy bladder only makes new cells to replace old cells.


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1 year 6 days ago #60432 by Waldo
We just got the biopsy results back and it has spread into muscle wall. As far as I know, LN, etc are still cancer free. I am heading home now and seeing Dr Narayan in Atlanta (waiting on a call back now). He is another a doctor in the practice that specializes in the next step-chemo IV or surgery.

Does the size of the tumor (9 cm) have anything to do with the type of cancer or the severity?

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1 year 1 week ago #60416 by joea73
The treatment and the prognosis depend upon the clinical diagnosis, which showed >3m tumor and at multiple locations. Also, it depends upon the pathology report of the tumors that the urologist had removed.

If the pathology report says the tumor had progressed to the muscle layer, it is classified as muscle-invasive bladder cancer. Usually, the doctor will recommend the removal of the bladder, or they may recommend bladder preservation treatment.

If it is not muscle-invasive, it is classified as non-muscle-invasive bladder cancer. The treatment for non-muscle-invasive bladder cancer depends upon the risk. Because the tumor was > 3.4 cm and other tumors were found, it is classified as high-risk non-muscle-invasive bladder cancer. Usually, high-risk non-muscle invasive bladder cancer will receive intravesical BCG treatment. The prognosis of non-muscle-invasive bladder cancers is much better than muscle-invasive bladder cancer.

The test they have done seems to indicate no lymph nodes positive and no metastasis.

The staging for bladder cancer depends on how far cancer has progressed, how many lymph nodes are positive, and if it is metastasized to other organs. How far deep cancer progressed is shown as Tx. Nx shows how many lymph nodes are positive, and Mx shows if it has metastasized to other organs or not.

If it is non-muscle-invasive bladder cancer, It will be TaN0M0, TisN0M0 as Stage 0. If it has progressed to the connective tissue ( also called lamina propria), it will be T1N0M0 as Stage 1.

If it is muscle-invasive bladder cancer, it will be Stage 2 (T2N0M0) if cancer has not progressed beyond the muscle tissue of the bladder.

And so on. Over 70-75% of the people who are diagnosed with bladder cancer are non-muscle-invasive bladder cancer. Their prognosis (survival rate) is very good.

Best wishes

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1 year 1 week ago #60415 by Waldo

I am trying to help my parents. My dad (81 years old)had a cat scan on 12/14/20 after trying 3-4 antibiotics and thinking he had a UTI. Today, they were planning on doing the biopsy but they then removed the very large tumor and a couple of growths that the doc had not seen before. I am glad they remove the tumor as it was 9.4 cm!! Per the tests they have done so far, no spread has been seen in the pelvic or abdominal lymph nodes.

I'm trying to learn as much as I can prior to heading from CA to GA on Friday. I know I have to wait for the results but the tumor size really doesn't match and of the 'stages', except 4 but if it hasn't spread will it be a lower stage even tho the tumor is large? Thanks so much for any advice or help!

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