I got my pathology report back as Ta High grade aggressive

6 years 10 months ago #53574 by Hannah01
Uro follow different protocols with BCG the allow to hold it for two hours. Sometimes a second TURB since muscle is in biopsy...Good Luck!!

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6 years 10 months ago #53573 by Jfoutz
My Uro at University of Southwestern in Dallas will only allow you to hold it for 1 hour. I believe that is to try to preserve the bladder. It seems like a lot of the doctors have different protocols in the BCG treatment. Also my Uro did not do a 2nd TURBT since it wasn't in the 2nd layer even though they did not get muscle.

Wishing you the very best,
Janice

Hematuria 4/2016
TURBT 5/2016
BCGx6 7/2016
Reoccurrence & TURBT 2/2017
BCGx6 4/2017
BCGx3 7/2017
TURBT 10/2017
Gemcitabine X6 12/2017
Cytology negative 4/2018
Cytology negative 8/2018

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6 years 10 months ago #53563 by Alan
John,

As Jack indicated there are different protocols depending on the doc. Mine had me try and hold for 2 hours but, at the 5th and 6th it was difficult. Mine also had s different regimen doing a second 6, 6 weeks later. That group I could only hold 60-90 minutes.

While this is doable and even sometimes uncomfortable, it sure beats chemo and it works.

DX 5/6/2008 TAG3 papillary tumor .5 CM in size. 2 TURBS followed by 6 instillations of BCG weekly with a second round of 6 after a 6 week wait.
The following user(s) said Thank You: seattlejohn

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6 years 10 months ago #53561 by Jack R
John,

The most noted hold time I find for BCG or BCG with interferon 2 hours OR until the urge to void is great. Hold times beyond 2 hours are often specifically discouraged. Forced holding of BCG is also generally discouraged.

There is some discussion about hold times from two sources I greatly value.

See Dr. Mike O'Donnell, on page 13 of the following article:
thomaschallenger.com/wp-content/uploads/2011/10/Mike-ODonnell-Protocol-long.pdf

Also see Dr. Donald Lamm
askdrlamm.bcgoncology.com/category/bcg-contraindications/page/3/

From discussions on this site, as well as my experience during my continuing BC journey and multiple urologists, there are many protocols and procedures for BCG that differ from one doc to another.

Best,
Jack

6/2015 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
Tried Keytruda, stopped by side effects
Workin on a new plan for 2021

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6 years 10 months ago #53560 by seattlejohn
Thank you Sara Anne. Makes complete sense to me and I just wanted to get yours and others input on the matter. Also I added questions about the BCG timeframe for leaving it in the bladder? Can you please read my additional post about how long is the average timeframe for BCG treatment ie leaving it in the bladder? Thanks so much.

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6 years 10 months ago #53559 by sara.anne
A second TURB is indicated if there is any doubt about a diagnosis. The question here is probably what difference would it make in your treatment plan...what questions might it answer? High grade has been diagnosed and he is putting you on BCG. He says that he got muscle in the biopsy and evidently the cancer had not extended there, thus Ta. Not sure what more a second TURB would accomplish and general anesthesia shouldn't be taken lightly. Seems like you are in good hands.

Sara Anne

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