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cytology positive

9 months 1 week ago - 9 months 1 week ago #56769 by Alan
Sorry to hear your Mom passed recently. That can explain part of your Dad's mental state. Yes, they go through the penis. While it sounds barbaric it is much simpler than cutting through tissues that involve a much longer operation and recuperative time. As Sara Anne said they likely would hold him one night at this age and depending how quickly he would wake up. It really is mostly a non event for the majority with the risks factored in. How do they get the tumor out? Just a guess that it is pieced out whatever preserves the specimen for pathology the easiest and for the patient.

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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9 months 1 week ago #56768 by sopranosgal
Thank you for your imput Alan and Sara Anne. I am trying very hard not to influence his decision one way or another. He has gone through a lot in the past year with the passing of my mom. Although he is a "good" 92 year old, he has declined since her 8 months ago. I have a stupid question....when they go in to remove the tumors (turb ) I am assuming they go in through the penis? And if that is true, how do they get a 2" tumor out of the penis? :ohmy:

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9 months 1 week ago #56765 by sara.anne
First, I don't think that you and your dad understand the situation with non-invasive transitional cell bladder cancer, which is the kind most of us are diagnosed with. IF it is low grade and early all that might need to be done would be removal of the tumors by TURB. If it turns out to be high grade, BCG would be a consideration.

Only if the cancer has spread (and you won't know without the TURB) would traditional chemo even be considered. Radiation is not the treatment of choice for advanced bladder cancer in most cases. IF the cancer has spread (and your dad does not know this) that would be the time to consider whether treatments such as chemo are indicated for him.

I suspect that Alan agrees with me that NOT having a TURB is choosing discomfort and illness down the road that could be avoided. Yes, a TURB requires general anesthesia. However, it is usually a very minor procedure (which is not to guarantee that he might not have problems.) I much prefer it to dental appointments, but then I am dental-phobic (should mention that my late husband was an oral surgeon!)

IF it turns out to be worse than we expect, THAT is the time for the kinds of decisions your dad is considering. I realize that this IS a personal decision, but had to share and expand my thoughts. Won't mention it again.

Best of luck to both you and your dad.

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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9 months 1 week ago - 9 months 1 week ago #56763 by Alan
No decision (waiting) is a decision and not a good one. It could change the stage (potential for progression). As his cystoscopy shows 2 growths he needs to find the status of them. Yes, the TURB can be a bit more difficult for a 92 year old. Pre-op the way most set them up with EKG, blood work etc usually rule out most potential problems. I am not in his shoes so my comments are purely conjecture on what I would do at 92. That said, I would still do the TURB and at least know what I am dealing with and might even be the end of further treatments. If the pathology says low grade most of the time it is "waiting and watching", just a monitoring via cystoscopies. High grade? That is usually BCG immunotherapy which is far more tolerable than chemo however, let's cross that bridge IF it comes up. Radiation is usually not done.

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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9 months 1 week ago #56762 by sopranosgal
My dad is thinking of not having the tumors removed. He said if it is confirmed to be cancer he wouldn't go for radiation/chemo treatment anyway. I'm wondering how bad it would be if he waited a few months to have the test done again?

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9 months 1 week ago #56758 by Alan
Sopranosgirl,

I am just reinforcing Sara Anne's comments as I have been traveling the past week. AS she said your Dad has good health for a 92 year old so he should do well on this procedure. You should know what you need in a short time. Let's just hope for the best one day at a time. We are here to listen!

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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