Meeting today to discuss RC - what to ask?

Kathleen,
I agree with Pat, get out of dodge to Vanderbilt, you need a very qualified surgeon for this surgery. At her age I would thing the external bag would be the way to go. My husband has one since Sept. 14 2007, he has had no problems other than getting use to it being there. You need qualified stoma nurses to help her pick what bag is best for her body type, you have to try a few before you find the one that works for you. The surgery will be hard and her strength compromised but it all comes back a little at a time. Its good to know so its not a surprise to family, its all part of recovery. She will need stoma nurses to visit her twice a week for 6 weeks at home, that is a God send. She doesn't have to learn overnite, they are your best friends after the surgery, it all works out in time.. Ginger

Kathleen...thats not as disturbing an article as you might think...the mean age was over 80 yrs and 40% of the patients had T4 disease...the biggest problem in this age population is getting it diagnosed correctly pathologically and delay...
"
Extravesical disease was common in this population, and led to poor outcomes in many cases, he added, possibly because of reluctance and consequent delay by surgeons in deciding to take these elderly patients into surgery. "
With a complete physical workup on your Mother and her general overall health should determine what is the best diversion for her and her ability to be compliant with what diversion she has. Obviously you want a surgeon who is very experienced in doing this so i would take on the insurance company and try for the out of network Vanderbilt not someone who has only done 3 surgeries.
Pat

I just found a pretty disturbing article on RC and elderly patients:

www.modernmedicine.com/modernmedicine/Bladder,+Kidney,+and+Other+Urologic+Cancers/Cystectomy-over-age-80-Patient-selection-is-key/ArticleStandard/Article/detail/498999?contextCategoryId=40182

Kathleen

Today we meet with the Urologist to discuss RC for my Mom. I am unsure what to ask - as I do not see info anywhere pertaining to RC on a senior woman.

My Mom is 79, had superficial BC 4.5 years ago, and has been cancer free since, until 6-8 months ago when she was diagnosed with CIS. BCG knocked it out initially, but it returned. 6 more weeks of BCG, still CIS present. Yet another 6 weeks of BCG with the second drug - still CIS. Oddly, she is symptom free with this CIS. BCG never slowed her down at all - no negative side effects.

We are not in a big city - doc and his team do only 3 RC's a year. We hope to get a referral so her insurance will pay for Vanderbilt, 4.5 hours away. Not sure if the doc will write the letter of referral, as her young doctor does "do" this surgery (and perhaps is anxious to do another now).

I see the 3 methods of RC diversion discussed here, but never for a "senior" woman. My Mom is extremely active, and does not act/seem her age. She retired from teaching 5 years ago, only because she moved out of state, away from the beloved school where she had taught for decades. I always say she has more energy that I do. She recently complained of sore muscles in her arm - playing catch outside with my 6 YO son. She is not a typical 79 YO. I went with her to a local Oncologist's appt when she developed the superficial cancer, and he told her physically, she was at least ten years younger than her age.

My main questions:

Any tips to get the doc to write a letter of referral, so insurance will pay out of network?

What type of diversion is "best" for a senior woman? Her doc recommends the external bag - says it has the least complications and risk of infection.

Thanks for any input,

Kathleen
NE Tennessee