Been dancing around the fire trying to save my bladder since Dec 2015 treating HG TA and CIS with BCG. Had HG TA recurrence about a year ago. Along with it a second primary urothelial HG TA/CIS cancer in my right renal pelvis and ureter, and so right kidney and ureter removed. One year later after two more BCG maintenance cycles, the path report revealed invasive HG urothelial carcinoma in the prostatic fibromuscular stroma (pT2)...a third primary urothelial cancer! Uro called with the path results and indicated chemo followed by RC is his early recommendation. Haven’t yet been able to have a comprehensive conversation with him about the way ahead but scheduled for first available office appt in 3 weeks. He referred me to a medical oncologist who I will meet that same day to discuss the chemo I suspect. So right now a little shell-shocked! Was hoping to get some insights from those who have “been there, done that”, while still adhering to the philosophy of “maximizing the likelihood of dying from something other than bladder cancer”. I’m still grappling with the idea of several months of neoadjuvant chemotherapy followed by an RC and long recovery...is it all worth it? If in the process of chemo and surgery, my remaining kidney gets trashed, I have no interest in spending my remaining years on dialysis. Some questions:
1) Understanding how chemo is very hard on the kidneys, was wondering how I would fair with only one kidney enduring cisplatin and gemcitabine for 3 to 4 months?
2) How soon after chemo is the RC?
3) How tough is the RC recovery?
4) More prudent to skip chemo and go straight to RC?
Please know I will certainly be asking my Uro and the medical oncologist these same questions (plus many more) when I meet with them. I was just hoping to have some insights beforehand. Appreciate everyone’s thoughts. Thanks!
12/15 - Diagnosed Ta HG, 1.5cm Pap, Focal CIS
3/16 - Began BCG following NCCN and SWOG guidelines
2/19 - Ta HG recurrence and CIS/Ta HG in right kidney/ureter
2/19 - Nephroureterectomy to remove right kidney/ureter
9/19 - BCGx33 completed
2/20 - Invasive HG urothelial pT2 in prostate stroma