How do you know of cancer before the TURBT?

8 years 7 months ago #43209 by jswim789
I've been reading more about BC and one item that puzzles me is that I see that intravesical chemo can be considered shortly after the TURBT as it appears to reduce the recurrence risk. But in my case, I didn't know anything until a week later when the pathology report came back. Basically it went like this for me:

- office cystoscopy - just looking with the camera
- TURBT 1 week later
- pathology report 1 week later

My tumor was about 7 mm. Perhaps others are bigger so the urologist can sample a bit before the TURBT? Or do others have a pathologist that works very quickly immediately after the resection?

Just puzzled more than anything else. I feel like I'm out of sequence compared to others.

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8 years 7 months ago #43210 by mmc
If they are suspicious, they will do the mitomycin. Best to ask your uro what was done.

Most of us don't get "samples" before. There is a reason we are asleep. Some folks have had small spots biopsied without being under but it put me through the roof when mine tried to do that.


Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results....distant mets
2/2014 ct result...spread to liver, kidneys, and lymph...

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8 years 7 months ago #43227 by sara.anne
Replied by sara.anne on topic How do you know of cancer before the TURBT?
Mike is right! (Mike is always right!) While the urologist may have some suspicions after cystoscopy the only definitive diagnosis comes after the path report is in. Cystoscopy allows shows him the areas he might want to concentrate on during the TURB. Mitomycin is just a precautionary procedure.

And, big or small, a tumor is tissue. You wouldn't want the doctor snipping at it unless you are under anesthesia! Occasionally, they will take a very small sample (very small and VERY shallow) during a cystoscopy, My uro did this once when, after a lot of BCG treatments, he saw lots of irritation in the bladder. He wanted to be sure that it was from the BCG. He was sure that it was, but wanted to check to we agreed that he could take a very small sample . I survived it!

During the TURB, the urologist is trying to get a large enough sample to assure that there is some muscle and the entirety of the bladder layers. It is critical that he/she is able to assess not only IF there is cancer, but how far into the tissue it may have spread. Often you will be called back in several weeks for a repeat TURB
to recheck areas that may be uncertain.

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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