CIS after papillary tumor

Your pathology report says TaG1.   G1,G2,G3  are a bit older classification, still in England it is the recommended grading system.
WHO changed in 2004 to papillary urothelial neoplasm of low malignant potential (PUNLMP), and LG and HG carcinoma.    Your pathology is TaG1 and papillary type, which rise into lumen of the bladder.  Ta means the tumor has not penetrated through the basement layer.  G1 means either it was PUNLMP or LG.  TaLG is stratified as low risk.   Statistically, TaLG has recurrence ( rise of a tumor or tumors, at the same place or difference place of the bladder) about 30-60% in 5 years.  But progression to HG or CIS is rare (5-15% depending on studies).  CIS looks HG under microscope, but had not penetrated through the basement layer.   Now a days, they can analyze entire DNA sequence of the tumor rather in expensive way.  So, they have done DNA analysis for muscle invasive tumor and non muscle invasive tumors.  The profile of gene mutations between muscle invasive and high grade/cis are similar.  That is why we need aggressive treatment such as by BCG.  But, the profile of gene mutations for LG is different from the profile of HG.  The prominent differences are that LG tumor has the mutation in fiber growth factor receptor genes (FGFR) , and HG or muscle invasive has mutation in TP 53 gene which is considered as tumor suppressor gene.  So, often LG and HG are mentioned as different cancer.  So, it makes sense that TaLG or TaG1 are treated with TURBT only followed by regular cystoscopy.    I agree bluelight helps the confidence level of cystoscopy, but I think they are used by large hospitals in the US and not much in England I guess.   I understand your having anxiety especially they found something in cystoscope.  I get anxious for annual cystoscopy too.   But, odds are in favor for you to have LG again if it happens to be tumor.   best luck

WHO grading

......G1...........G2............G3........
PUN........LG.........-HG.............

Lining of bladder

OOOOOOOOOOOOO  Superficial layer
00000000000000000
00000000000000000    Intermediate layer               Ta region
00000000000000000   
oooooooooooooooo    Basement (Basal) layer

Connective Tissue (Lamina Propria)     T1 region

Muscle Tissue   T2,T3  region
Fat

Is it hard to see CIS on a cysto?

My Urologist did a followup TURBT with blue light cystoscopy  a couple of months after my initial TURBT and discovered CIS. He said he was glad he did because he found a "small" patch on the upper bladder that he probably would have missed. In fact he said he had to have an assistant push down on my bladder during the procedure in order to remove it. I had an infusion of "Cysview" prior to the surgery and makes the CIS glow using the ultraviolet light. He actually gave my wife photos of the tumors while I was in recovery. You could see the patch clearly distinguishable. 

So yes, it seems that it might be hard to see CIS in some cases. I'm sure it depends on location, experience of the physician,  and lots of other variables.'
 
I looked at some of your former posts and didn't see a mention of BCG so not sure if you were treated with. In my case I had 24 total treatments and so far so good going on 5+ years. In fact I just went on a 1 year surveillance cysto (YAHOO!!) this last month.

Anyway - Good luck.

Peace and Love!!

Is it hard to see CIS on a cysto?