Early recursion of bladder cancer - within 2 moths of TURBT operation

Update:

 I have cystoscopy and TURBT on 8th Aug, 2023. Biopsy report shows
1. Negative for Malignancy (No Cancer)
2. Some distorted scar with calcification

After seeing the report doctor told:
1. Its was scar from 1st TURBT, and not cancer this time
2. Next appointment is after 3 moths to recheck again - doctor told I may get a bigger scar next time

So this is good news for me as Cancer is not back rather it was a post operative change of 1st TURBT.


Update:

I have done the following 2 tests:

1. Urine Cystoscopy - result shows negative
2. Pelvis MRI - shows 0.4 mm growth with mild perivesical fat stranding.

After checking in google - I rushed to doctor as I thought my cancer has become stage 3 because of the finding "mild perivesical fat stranding"

This is what doctor told:
1. 90% chance its a scar and not cancer as its in same place as before, where they operated
2. 1% chance of this being muscle invasive or stage 2 or 3. He told "mild perivesical fat stranding" maybe because of post operation (TURBT) effect from 1st operation.

My cystoscope is scheduled coming Tuesday.

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There are always exceptions, but it is known that low grade will not change to high grade.   Cancer rise because of malfunction/mutation of genes.   Sometimes low grade and high grade are different cancers because low grade and high grade tumors have different profile at gene mutations.  60% of low grade tumors have mutation in genes (FGFR) from which Fibroblast Growth Factor Receptor (FGFR) protein is produced.  When a cell which makes up the lining of bladder gets old, our body sends a signal to replace it with new cells.  Only when FGFR receives the signal, FGFR initiates metabolic process to produce new cells.   When FGFR gene is mutated, sometimes FGFR protein initiates metabolic process of producing new cells even  without receiving the signal from our body.  In this way, cancer cell continue to multiply without stop, growing the size of the cancer tissue.   But low grade cancer will not break through the basement or basal layer of the lining of bladder  into connective tissue and to muscle tissue.  

High grade tumor tend to show mutations of different genes, especially TP53.  P53 protein which is produced based on TP53 gene template plays very important role in suppressing the creation of tumor.  P53 protein involves in initiating apoptosis ( self death) of cells of which DNA was damaged and cannot be repaired.  When P53 protein does not function properly because TP53 gene mutation, our body will allow  DNA damaged with gene mutation cell to live and reproduce.   High grade tumor if not treated can progress to connective tissue and muscle tissue.  As muscle tissue have many  blood vessels and lymphatic vessels. bladder cancer cells can get into a blood vessel and lymphatic vessel and circulate in the body and land to other organs and grow as metastasis.   

There are a few generally accepted reasons of high recurrence of non muscle bladder cancers.  One is that fragments from the original tumor implant to the lining of bladder during the initial TURBT.   The guidelines recommend that when urologist thinks it is low grade in cystoscopy, intravesical chemotherapy is administered within 24 hours.  Statistically, this procedure has reduced about 10% of recurrence.   Another reason is that toxicity which was excreted from kidneys, which could have contributed in the rising of cancer was also affecting other parts of the lining of the bladder.  

Thank you for your write up.
Today I am going for check up, wish me luck