Congrats on the good progress! The only thing I might ask for if it was me is the cytology test, especially being non invasive and not super expensive....understanding it often shows false positives. Probably not a major issue.
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.
Hi. Just wanted to give an update. My uro did a cystoscopy for me in November - and he did not see any abnormality in my bladder; no polyps/tumors, etc. My first cystoscopy was April last year with same results. He scheduled another follow-up cysto in 6 months.
He did not see a need for cytology or tumor marker tests at the time. Should he be doing something additional at this point? Many thanks. Blessings.
Hi Beto, glad to know that you were able to sorted out the CT urogram insurance issue.
Moffitt cancer center website says " A mass (tumor) that is found on the bladder – the muscular sac in the pelvic region that stores urine – can sometimes be indicative of bladder cancer. In other cases, a bladder mass could be a benign (noncancerous) polyp, which is a small, cauliflower-like growth that can potentially turn into bladder cancer in the future."
It takes several years for a normal cell to become a cancer cell. It requires 3-20 accumulated mutations in protein-coding genes. It may take several years for one mutation to occur, and it make take another several years for another mutation to occur. A cancer can grow max 2mm on its own. New dedicated blood vessels need to be developed to provide oxygen and nutrition in blood to help the cancer cells continuing dividing (growing). So, it takes several years from a normal cell to become a cancer cell, and the cancer cell to divide to become the size which can be detected either by CT or cystoscopy. I think the tumor (benign or malignant) was there 4 months ago, but it was small enough that the urologist could not detect by cystoscopy.
According to a 1989 study by a French group, different cancer type showed different growth rate .
Embryonal tumors 27 days
Malignant lymphomas 29 days
Mesenchymal sarcomas 41 day
Squamous cell carcinomas 58 days
Adenocarcinomas 83 days
In terms of bladder cancer, a Israel group checked how fast a recurrent low grade tumor grow.
The result is as follows.
If the initial tumor size was less than 4 mm (32 patients), in average the recurred tumor grew about 5mm3 each month.
If the initial tumor size was greater than 5 mm (6 patients), in average, the recurred tumor grew about 1000mm3 each month.
It seems to indicate that the growth speed of bladder cancer differ among patients even if the tumors are same low grade.
"A computerized tomography (CT) urogram is an imaging exam used to evaluate your urinary tract, including your kidneys, your bladder and the tubes (ureters) that carry urine from your kidneys to your bladder.".
My clinic requests authorization for a "CT of the abdomen/pelvis, with & without contrast". This is just a more complete way of describing a CT Urogram. Everything from the kidneys down is suspect and must be checked out.
Once I was diagnosed with bladder cancer, the procedure was extended to a "CT of the chest/abdomen/pelvis, w/wo contrast" to monitor for spread.
Your doc's office should be able to straighten this insurance company misunderstanding quickly.
6/2015 HG Papillary & CIS
3 Years and 30 BCG/BCG+Inf
Tis CIS comes back.
BC clear as of 5/17 !
RCC found in my one & only kidney 10/17
Begin Chemo; Cisplatin and Gemzar
8/18 begin Chemo# 3
Begin year 4 with cis
2/19 Chemo #4
9/19 NED again
1/2020 CIS is back
Tried Keytruda, stopped by side effects
Workin on a new plan for 2021
I have no knowledge for CPT procedure code for CT scan. But, Radiology Associates of Hartford, Connecticut has published the 2019 CTP codes for CT and MRT. The document says the CTP code for Urogram with or without contrast is 74178.