WEll, no phone call from my uro.. which ticks me off, he has all three of my phone numbers. Now I have to wait for after-hours tonite, I guess.
Thanks for the words, Connie. I feel bad asking friends to take time off to be with me just because I'm scared.. I'm physically capable on those cysto-days, so I don't want to be a baby. Maybe that's the hardest part about not having a significant other when you are living with cancer - you just don't want to bother anyone else till it's reeeeeaaaaalllly bad, or you feel like a big fat imposition, or a big fat baby, one or the other OH, and the other part - the friends are scared, too, and it's even harder to be around them when they look at you like they are seeing you in your burial shroud, for heaven's sake!
Ah, too much to think about right now. I'll just play the waiting game another day, and smile! You smile, too, Connie.. in my experience, I'd much rather come home to my three dogs than either of my ex-husbands anyday, which does not portend well for any man who might aspire to being my 3rd husband!! ;D
I'm hoping with all my might that your pathology comes back low grade. I'm going to a dinner at the Cancer Support Center tonight, and will look when I get back to see if you've posted results. I know about that shakiness. I take a tranquilizer before appointments to quell it somewhat. That makes me a sedated driver, but I have no one to drive me, either. I almost always have to go straight to work from the urologist appointment, no matter what news I've gotten or what I underwent. It's hard sometimes.
Oh yes, I've been having "poke and peeks" (three since the initial diagnosis and TURB in Dec 05)... and cytology every six months. The inital TURB was done in the hospital after a CAT scan with IVP discovered the tumor. Last week, my uro said what Connie said - he could biopsy right now,and fulgurate, and IF the pathology is not what we want to see, I will need a TURB in the hospital to check the muscle layers, and then we'll discuss other treatment options. My inital tumor was very low grade TaG1. I'm glad it happened this way - although it was a bit painful, it was done quickly, no affects from anesthetic to deal with, and I was given Cipro, a technician was helping, etc... I only wish I'd known before and i would have had someone drive me - my only complaint - as I was a bit shaky afterwards..
Connie...perhaps i read Lauren incorrectly. Perhaps she has had several poke at peeks at 3 month intervals ...i really don't know her history so i should not have made assumptions. I would however think a "shrub" like tumor after 2 years might just require a further TURB and it sounded like thats what he attempted to do. I'm hopeful that she indeed has had due dilligence with her management of this disease. Maybe she will jump in here and clear this up. Pat
I always thought that the office "snip and zap" was the taking of a biopsy or biopsies, then burning away of remaining tumor, whereas a TURB is the removal of the whole tumor or tumors in the O.R., plus taking some of the lamina propria and going into the muscle to get a sample to check for invasion. Please correct me if I'm wrong, as I'm trying to get my terminology straight. I was under the impression that Lauren had a TURB originally, then the office biopsy/electrofulguration for the recurrence.
I know in my case, most of one tumor I had was "cut out" for biopsy because it was so tiny to begin with...there wasn't much left after the biopsy was taken.
It's true that an office biopsy will not get any lamina propria, and therefore it would be impossible to see if any invasion had taken place. But for a person who has had numerous low grade tumors, I can see where it would save wear and tear on the bladder to not do a TUR every single time. Having gotten bladder cancer at a relatively young age, I wonder if the treatment is going to eventually cause more problems than the disease.
These posts are about biopsy and electrofulguration in the office, not TURBs in the office. Two different things --just wanted to clarify. TURBs (resection) in the hospital are done after the initial diagnosis of a tumor(s) in the bladder. In the case of someone with a history of small, low grade tumors, then there is the choice of office vs. hospital if the urologist offers the office procedure option. Either way, you get a pathology report. If, against the odds, the path report comes back high grade, then a TUR in the hospital is done to the necessary muscle tissue.
I don't think the issue is a misunderstanding of the difference between a TURB and an in office procedure. My question is whether removal of a bladder tumor in the office can provide adequate staging. That would not be an issue if staging doesn't matter for low grade cancers, but while it's clear that high grade tumors pose a greater risk, I don't believe (not an expert opinion. I'm not a urologist or a bladder cancer maven) that low grade is synonymous with lack of invasion or evidence that invasion hasn't or won't occur... and it is staging, more than grade which ultimately determines treatment options.
Perhaps I would see the issue differently if I ever had a low grade tumor, or if I had had to deal with multiple recurrences, but I would be most uncomfortable getting rid of a cancer without knowing how invasive it was since any invasion requires more than just getting rid of the cancer.
TaG3 + CIS 12/2000. TURB + Mitomycin C (No BCG)
Urethral stricture, urethroplasty 10/2009
CIS 11/2010 treated with BCG. CIS 5/2012 treated with BCG/interferon
T1G3 1/2013. Radical Cystectomy 3/5/2013, No invasive cancer. CIS in right ureter.
Incontinent. AUS implant 2/2014. AUS explant...