transitional cancer

14 years 11 months ago #608 by Jeff_Gill
transitional cancer was created by Jeff_Gill
Hi,
I’m 59 been in good health all my life.
Smoked cigarettes 45 years quit in 2003. Since 1970 had 3 kidney stones passed 2 on my own.
In 2004 the V.A. found blood in my urine and that I had a large kidney stone.
About a month later they removed the stone by ultrasound and found and removed a small pea like tumor at the bladder neck. This came out to be nothing.
May, 2006 out of bed with a bad backache about 4 hours later pissed blood thought it was another stone. Called the Doctor he said to go to the nearest E.R.
They did some blood and urine work, chest X-rays and a CAT scan.
The ER doctor came in and told the wife and me I had advance Prostate cancer. He called an urologist for me to see the next morning.
He sent a scope up and saw a tumor did urine work and found cancer cells.

June 5,2006 checked into Hospital for Biopsy.
He needed to shave off part of the prostate to see the tumor and used this (shavings) also for biopsy then he did a separate Biopsy on the tumor. He told us this was like mixing everything thing together as a blob.
Appointment today with Urologist June 13,2006
The Lab was scratching there heads as what they see is very rare I have transitional cancer they don’t know if it started at the prostate or the bladder or I have two cancers.
So the biopsy is being sent to University of Washington either way I’m going to lose bladder, prostrate and maybe the tube going down penis.
What a shocker today has been. This is very hard for us to deal with.
This Friday I get chest X-ray and a bone scan.
The only good thing happening today was I had that catheter removed and he told me I could have a drink.
Any advice or someone who has been there would be helpful.



Thanks

Jeff


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14 years 11 months ago #610 by cta7978
Replied by cta7978 on topic transitional cancer
Yeah, from what you have written its not clear if you have bladder cancer that has spread to the prostate or two seperate cancers (bladder and prostate) that have been growing independently on their own.

Can't comment on the seriousness of your Prostate cancer, but quite a few people on these message boards have had the operation you mention (bladder + prostate removed) and are doing pretty good with the different types of rebuilt bladders.

On the bright side, if the doctors are talking to you about removing the bladder, prostate and urethra, then it would appear they figure you have a good enough long term chance with the operation to proceed.

Good luck.

Chris A.
Diagnosed T1G3 - 3/01/06
37 yo, Seattle, WA

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14 years 11 months ago #611 by Jeff_Gill
Replied by Jeff_Gill on topic transitional cancer
Chris,
Thanks for thr reply.
It's been a scary couple of days for me and the family.
Mostly due to not getting the 2nd biopys results.
Alot of stuff runs through the mind as I would think all here have gone through.
You have given me some hope.
Thanks,
Good luck to you too!

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14 years 10 months ago #773 by patrick
Replied by patrick on topic transitional cancer
:-* :)
I was recently diagnosed in march 2006.  I had tumor removed in mid march and went through six weeks of bcg therapy.  I had a cystoscope done last week and they found 2 new spots.  they will biopsy the new spots 7/5/06.  If cancerous, I will be sent to Indianapolis for the neobladder operation.   [smiley=undecided.gif] is there anyone who has been to indiana university medical center for this procedure.  please respond with your opinion and story about this surgery.  My wife and I are considering basic bladder removal in the interest of saving time.  We could probably have basic removal done a bit faster and locally.  I am only 55 years old and am in fairly decent shape.  Any opinions on my case woulkd be appreciated [smiley=grin.gif]

                                                                  Buckeyeboy

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14 years 10 months ago #775 by rolsen64
Replied by rolsen64 on topic transitional cancer
Buckeye Boy,
Whoaa!!!  Slow down.  This is not a simple appendectomy.  You should get a second, even third, opinion before doing anything rash.  If you do need to have your bladder removed, you want a urological surgeon with a LOT of experience with genitourinary cancer surgery and bladder removal in particular.  These are complex procedures.  When done by the experienced uro/surgeons, the operating time between the 3 types of procedures is not significant.  If you go to the section on urinary diversions, you'll find info on the 3 different options.  Email direct if you can't find it, and I'll send it on to you.  Also check Tales From the Trenches (Ben Olsen is my husband).

In the meantime - some general info on bladder cancer:
Approximately 50,000 new cases of bladder cancer will be diagnosed this year, 14,000 will require radical cystectomy (RC) and urinary diversion.   Bladder cancer is not a death sentence.  When diagnosed early and treated appropriately, the long-term prognosis for bladder cancer patients is very good.  It is imperative to learn as much as possible about the disease and treatment options.  The p53 & P21gene tests, developed at the USC/Kenneth Norris Comprehensive Cancer Center, Los Angeles, are used to evaluate tumors to help determine likelihood of tumor recurrence and treatment options (they are available at USC/Norris and a few other places).  Also, Matritech's NMP22 test, FISH and BTA Marker tests are used for tumor evaluation.  Accurate diagnosis and treatment are critical at all stages.  

It is important to find a urological surgeon and a pathologist who have both the skill and a LOT of experience to determine the most accurate diagnosis and best treatment.  Since most urologists & pathologists see very few cases of bladder cancer, one usually has to go to one of the comprehensive cancer centers for the best treatment.  In many cases, patients can be successfully treated with careful monitoring - a minimum of cystoscopy every 3 months and annual IVP, CT scan, TUR.  Some may also require BCG and/or one or more of the chemo programs.  Others will require radical cystectomy, a major surgical procedure.  A very small number of patients who meet strict criteria may qualify for bladder-sparing treatment.  This involves a combination of chemo and radiation.  Patients who qualify for bladder-sparing treatment should be aware they may be limited to an ileal conduit with an external bag (instead of one of the continent internal pouches) if radical cystectomy is ultimately needed.  In all cases, the skill and experience of the surgeon are critical and should not be underestimated.  Typically, if the cancer is invasive AND confined to the bladder, RC and a meticulous lymph node dissection can be completed BEFORE chemo is considered.  In many cases chemo is not necessary.  There are a few options for chemo, which are usually determined by the patient's diagnosis and/or the doctor's preference.  Radiation therapy should be avoided if possible, because it can cause irreversible scarring and damage the entire intestinal area.

For cases requiring bladder removal, the standard ileal loop urinary diversion and a variety of internal continent pouches are available.  The ileal loop has an abdominal stoma and requires an external collection bag.  It also requires "hooking up" to a night drain when lying down for more than a few hours.  Some of the internal continent pouches have an abdominal stoma, and they are drained through a catheter 4 - 7 times/day (easy, painless and simple).   They are easy to manage and do not require an external bag.   In many cases, the internal pouch can be reconnected to the urethra to allow for normal urination.  This procedure frequently requires a period of training before continence is achieved, and some people never achieve 100% continence.  In some cases, nerve-sparing surgery can be done to help maintain potency for males.  If not, there are a few good alternatives to impotence.  Email for info.

Bladder cancer is a nasty, insidious and frightening disease.  Although many people are successfully treated with regular Cysto checkups, TUR, BCG, BCG and Interferon and/or other chemo drugs, and/or RC, far too many are not as fortunate.  They later find their bladder cancer has spread out of the bladder (metastasized).  Some of these metastases may have been avoided with accurate pathological staging and grading of tumors.  Even patients who undergo successful RC need to have regular checkups.  

The three most common types of bladder cancer may be found separately or in combination.  All three can develop from "superficial" to deeply "invasive" tumors.  Superficial means on or near the surface - it does NOT mean trivial or insignificant.  Deeper tumors are called invasive.  Papillary tumors stick out into the bladder like a mushroom and can also send shoots down into (and through) the bladder lining.  Sessile tumors are small surface craters and also send roots down into (and through) the bladder lining.  Cancer in situ, CIS, is microscopic spots on the bladder lining.  Unfortunately, staging and grading tumors is not an exact procedure.  It is often difficult to obtain the complete outer edges of tumor tissue, including areas of CIS.  If the O - D staging method is used, O & A are superficial, and B, C, D are invasive.  Grading is determined by how much the cell structure differs from a normal cell.  If the I - IV staging method is used, III & IV are the most threatening and require aggressive treatment.    

The occurrence of any type of bladder cancer indicates the bladder tissue is unstable and highly susceptible to malignant growth.  Transurethral (TUR) surgery and pathological staging and grading can neither guarantee the cancer has been cured nor that tumor will not recur.  The hard truth of the matter is that bladder tumors have a 50 - 70% recurrence rate with no set pattern or predictability, and recurrence may be a more invasive type of cancer.  Accurate pathological diagnosis and appropriate treatment are critical in all phases of bladder cancer treatment.

Check your library for a copy of Dr. Mark Schoenberg’s excellent book, “A Guide to Living With Bladder Cancer” which has good information on everything, including chemo.  It is also available at most bookstores and at Amazon.com, Barnes&Noble, etc. – about $16.00 US.  

Also, happy to answer questions e-mail or phone, but there is a lot of ground to cover.
Best,
Roni      
This email address is being protected from spambots. You need JavaScript enabled to view it.
(I am not a medical professional - just a graduate of "trial by fire" as my husband successfully battled bladder cancer 20+ years ago and a LOT of research).

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14 years 10 months ago #848 by Mike
Replied by Mike on topic transitional cancer
Do you know of any instances where a pouch or neobladder was refused? and, if so, the reason? I have an appointment with a specialist this week and am so much hoping he will accept me as a patient for this procedure.

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