What are the odds of recurring non-invasive CIS/Dysplasia Upstaging??

Dave, I have not experienced the protocol you asked, however I have read several articles that stated the recurrence of non muscle invasive tumors did not increase the risk for muscle invasion. This was an article on CIS. The prognosis of patients with CIS is variable, many develop progression, however others continue for years without progression. I have alsos read that not all CIS lesions progress to invasive. There are also studies that distinguish between focal and diffuse CIS with focal being the "better" of the two. As to dysplasia one study indicated that this may be a precursor to the development of carcinoma however this is not an inevitable continuum in humans.

Joe

Thanks, Tim for your lone but very knowledgeable response.

Perhaps I'm just in denial concerning the inevitability of radical cystectomy for all cases where BCG fails -- even though tumors remain non-invasive ---, but I thought there were folks on the forum (can't remember just whom right now) who had gone through multiple TURB and papillary tumor resections --- and even some recurrent dysplasia, but no upstaging to invasive --- over several or more years, and I was looking for some confirmation of that.

Perhaps I wasn't very clear on how I phrased my post?

Anyway, here goes again: Does anyone out there have a history of multiple TURBT w/papillary and dysplasia--but no invasive tumor detected---, perhaps combined with poor reaction to BCG? (bearing in mind that recurrences of dysplasia following BCG may not necessarily indicate failure of BCG??).

hopefully,

David Doyle

(next TURBT sched for June 27 -- this will be the fifth since April of last year)

Ddoyle

Different studies suggest different odds but you're probably in the region of 25 - 50% over a 5 year period. my docs told me that, left untreated, my cis would be likely to "progress" within two years follwoing discovery. of course that doesn't mean it'll happen. you've posted before on your ongoing situation so I won't repeat verbatim what I think. except to say that you're clearly in a high risk situation. from the other side of the op, cystectomy isn't that bad. it's not nice but, given a successful op, you'll be amazed at how little it impacts your life in the long term.

all the best

tim

After 5 TURBTs and countless cystoscopies and a round of TORTUROUS :-X BCG last year, my latest cysto shows what "looks like" CIS (but could be dysplasia). Will have yet another TURBT on 6/27 and the doc is again hinting at RC due to my apparent lack of response to BCG. Since the BCG last June which caused extreme inflammation which lasted even until now, I have had several cystos which showed papillary growth and what appeared to be CIS (red, inflammed or ulcerated areas) but after biopsies turned out to be non-invasive dysplasia. What are the odds of this recurring problem upstaging to invasive?? I am not ready to concede and let him take my bladder, even though he seems to be losing patience. Any ideas?