New to forum with some information needed

1 month 4 weeks ago #62094 by Alan
Welcome Paul,

If you have any doubt, I'd get a second opinion. Preferably at a major bladder cancer practice. One that sees a lot as so many do mostly prostate issues with men or, a teaching hospital/university setting. Like MD Anderson, Cleveland Clinic, Sloan Kettering, Northwester etc.
However, it does sound like your URO is doing what needs to be done. That recurrence could have simply been missed being small, was in its' infancy among other possibilities as Joea enumerated.

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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1 month 4 weeks ago #62093 by joea76
Replied by joea76 on topic New to forum with some information needed
Hi Paul,

The quick answer is No.  It is possible for new tumors to arise in short period.   The word recurrence is often loosely used. Below are 
  •  Implantation of  fragments of the original tumor from the initial TURBT .   To reduce this risk,  if the tumor looks low grade during cystoscopy,  one instillation of chemotherapy drug is administered within 24 hours after the TURBT,
  • The TURBT did not resect wide enough to remove residues of cancer, which were not visible, and tumor rose from the residues.   
  • Because most bladder cancers are result of the lining of the bladder has been exposed to toxic molecules which are excreted from kidneys over so many years, the lining of the bladder has transformed and it has become for tumor to rise.  This situation is called Field Effect or Field Cancerization.   
  • Large percentage of low grade tumor contain abnormality in genes so called Fibroblast Growth Factor Receptor (FGFR).  One of FGFR's function is to initiate cell division cycle.   Usually cells of the lining of the bladder renew every 100-200 days.  Our body knows when cells in the lining of the bladder need to be replaced with new cells, and sends signal to request to start cell division cycle. Only when FGFR receives the signal, it initiate a cell division cycle to replace the old cell with two new cells.  But, with abnormal FGFR, cell division cycle is starting even when our body sends signal for cell division.
Low grade and high grade tumors are considered as different not only by looks under microscope but in molecular composition, e.g. FGFR gene mutations.  Low grade will experience recurrences, but they rarely changes s to high grade which has characteristics of progressing to muscle tissue.   I hope the frequency of recurrence becomes less as your BCG treatment contitues.
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2 months 15 hours ago #62088 by PaulBelfi
I was diagnosed with bladder cancer back in Jun 2023... I had no idea that I had this disease had I not seen blood in my urine... I immediately thought I may have possibly had a UTI , but when a urinalysis was done, it showed no UTI or bacteria! I then went in for an MRI and that's when they saw two tumors, and from there I was referred to a urologist. After doing a scope he said that I did have two tumors, that seemed low grade from a visual inspection and would have to be removed by TURBT surgery and then sample sent to a lab ...The results came back as low grade tumors, which was a relief! The doctor then told me that  he recommended going in for BCG infusions (once a week for 6 weeks) HOWEVER, when I went for a follow-up after the TURBT, he did another scope and saw that there were two small tumors that recurred...from that point the BCG was cancelled and I had to go in for a second TURBT! After the second TBURT was complete and samples sent out, the pathology report came back as low grade tumors and non invasive ! I am now into my third week of BCG infusions, but my question it odd to have low grade tumors reacurre so quickly? 

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