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How does bladder cancer travel to

3 years 10 months ago #51694 by rkp
Thank you Sara Ann and Jack
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3 years 10 months ago #51693 by Jack R
Sara Anne,

One paper on the need for a second TURBT is listed below. Additional journal articles are cited by this paper.
Importantly, the paper points out the uncertainty of results from a single test, and makes the case for regular and repeated follow-up examinations being absolutely necessary.

Best
Jack

http://www.ncbi.nlm.nih.gov/pubmed/20929433

What's with this Bleeding ? 6/2015
DX: HG Papillary & CIS
3 Years and 30 BCG/BCG+Inf
Tis CIS comes back.
BC clear as of 5/17 !
RCC found in my one & only kidney 10/17
Begin Chemo; Cisplatin and Gemzar
8/18 begin Chemo# 3
Begin year 4 with cis
2/19 Chemo #4
9/19 NED again :)
1/2020 CIS is back...
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3 years 10 months ago #51692 by sara.anne
Excellent article and point, Jack. It has been known for some time that an initial TURB is probably not sufficient for a good diagnosis, and especially when CIS is involved. Many top urologists routinely usually do a second TURB about a month after the first and it has been shown (I wish I still had the reference...maybe someone does) that this increased the accuracy of the diagnosis significantly.

In my own case, the intial TURB showed papillary transitional cell carcinoma, low grade...but there were some areas of "irritation" also present. A month later a second TURB allowed my urologist to concentrate on the irritation areas and, sure enough, they were CIS. The treatment plan for each of these diagnoses would have been quite different!

This is a point that needs to be mentioned more often!

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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3 years 10 months ago #51691 by Jack R
Rebecca,

After having a quick return of cis after bcg and a clean checkup, I began wondering if it was a "return" or "missed" cis.

If it was missed cis, I wondered how accurate the biopsies taken at sites of visible cis and "random" sites really was. My biopsies were whiteulight, no blue/flourescent offered.

The following article may provide one answer to your question. It has made me cautious of attempting to retain my bladder too long unless results turn and stay positive. As always, this is ONE article, and offers one conclusion.

http://www.ncbi.nlm.nih.gov/pubmed/22321341

Upstaging of urothelial cancer at the time of radical cystectomy: factors associated with upstaging and its effect on outcome.

Best
Jack

PS. I have been accused of reading too much.

What's with this Bleeding ? 6/2015
DX: HG Papillary & CIS
3 Years and 30 BCG/BCG+Inf
Tis CIS comes back.
BC clear as of 5/17 !
RCC found in my one & only kidney 10/17
Begin Chemo; Cisplatin and Gemzar
8/18 begin Chemo# 3
Begin year 4 with cis
2/19 Chemo #4
9/19 NED again :)
1/2020 CIS is back...

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3 years 10 months ago #51685 by DougG
Rebecca,
How smart you were to go to Emery for the second opinion. Best wishes With the chemo and radiation.

Anita
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3 years 10 months ago #51682 by rkp
Thank you Cynthia for the response. I will update .

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