I was diagnosed with a Ta tumor in December. It was removed by TURBT, single tumor, and small. I was given the Mitomycin right after the procedure. I am a non-smoker. The questions I am having center around the pathology report. I was told by my doctor it is 99.9% low grade with a tenth of a percent high grade. The path report states: predominantly low grade with focal high grade. Because of that, my urologist offered me BCG. I asked him what he would do and he said he would wait and not do it now. I went for a second opinion at Mayo. They scoped me again (30 days post op with all clear) They confirmed the diagnosis, however the urologist there said that it was graded high grade, that I was an odd duck with the focal piece. I asked him if I should be on BCG and he said no as well. Both did not seem worried about it. I can't find much information when it comes to focal high grade in a low grade tumor. More specifically, what numbers should I be looking at when it comes to low grade vs. high grade ta tumors and what I have coming at me down the road. Where do I fit in the area of recurrence or progression. Probably an unfair question. I did find one article which said the following:
Although pathologists are generally taught to call
> things the highest grade, in cases like this the high grade area can be
> quite localized. Such a case is most clearly signed out as low-grade (or
> grade 1) TCC with focal high-grade (or grade 3) TCC with a comment as to
> how much high grade there is. There has been some recent literature in
> this regard but there I am not aware of a consensus. I get the feeling
> that these behave closer to low-grade, but I would not attest to it.
Anyone been in my shoes? Should I be concerned. I trust both urologists. The first one trained at Mayo and is conservative and excellent. The second one is excellent as well.