To Remove or not to Remove, that is the question

Hi Mike, I'm male (59 years old). I'm not worried about finding a specialist. I have the best in the country (U.S.A.). I'm being treated at The National Institutes of Health, the urology department. I'm under the best care I can imagine. I just can't see why I have to get my bladder removed since the CT scans have come back clean. I suppose that microscopic cells could be lurking, but I heard that cancer cells are floating around in the body all the time and that the immune system destroys them most of the time. Anyway I may have to get the RC. That is what most people advise.
Thanks,
Robert

Thanks for your reply Rick. It sounds like almost everyone stands by the RC. Maybe that is the way I should go too.
Thanks,
Robert - Garrett Park, MD

Good luck with your surgery on the 17th. Mine is scheduled for the 29th. - unless I cancel. Thanks for your reply.

Thanks Pat. I appreciate your response.
Robert - Garrett Park MD

rlemar,

I can't tell from your profile or your post if you are male or female. The choice of diversion when getting the bladder removed may be different depending on your sex.

There seem to be more positive outcomes for women with Indiana Pouch and for men with neobladder.

I had invasive and got my bladder removed in October of 2008. All my follow up tests have been all clear and I am very happy to be rid of the bladder and the cancer!

One of the MOST IMPORTANT things for you to do at this point is get to a major bladder cancer center for follow up. They will reconfirm your pathology reports and current situation and they have much, much more experience with bladder cancer since that is what they specialize in. Some call this a 2nd opinion. I call it getting to the right level of specialty.

Doing this is the primary thing that you can do to increase the probability of a successful outcome.

If you let us know where you are located, Pat has done (and continues to do) a tremendous amount of research on doctors that specialize in treating bladder cancer and doing radical cystectomies.

The scraping option does not have as high a probability of a successful outcome as the radical cystectomy.

Mike

rlemar,
You said they determined that the cancer has penetrated the bladder muscle. Since the muscle uses a blood source, there is always a chance that the microscopic cancer cells have been absorbed into the blood source.
My diagnosis was similar to yours. My doctor explained that the risk would be less of the cancer coming back if I had the RC. If there were microscopic cells present, the hope was that they had not gone into any other area, yet. As Pat said, the statistics show that bladder cancer comes back often. The key is what to do to minimize it from happening.
After my surgery, the biopsy showed that the margins around the exterior of the bladder were clean and no signs of cancer cells. That knowledge alone was worth going through the surgery. The diversion that I received is called an Illeal Conduit. The doctor used a portion on my intestine and connected one end to the kidneys and the other end stick outside my belly. I use and adhesive patch and bag to collect my urine. This diversion is not always people’s first choice, but sometimes it is the only choice available. I am very satisfied with my Ileal Conduit.
I had my chemo treatment after my surgery with the Cisplatin/Gemzar mix. Everything I read about radiation was pretty negative. Allot had to do with the damage the radiation caused with scar tissue and causing healthy organs from functioning normally.
Good Luck with your choices and health
Rick too