Diana, I thought that we had explained that the TURB is primarily a diagnostic procedure. While some small tumors of the papillary type can be removed, the purpose of the TURB is to provide samples of the bladder so that an exact diagnosis can be made. CIS is a bit like a rash on the surface of the bladder. Unless samples are analyzed by the pathology lab the urologist cannot tell if it is even cancer instead of another type of inflammation.
If the pathology report indicates that the situation is indeed CIS or another high grade cancer then BCG is the current standard for treatment. If it is NOT CIS or high grade BCG would not be indicated.
There is nothing new in this. The usual sequence is that the urologist does cystoscopy and sees that there is apparently something abnormal. He then does a TURB under general anesthesia and cuts out small samples for analysis. Only after a review of the pathology report will he really know a. Is it cancer? b. Is it CIS or high grade? c. Is it still noninvasive? Often there are still questions and a second TURB is necessary before a treatment plan is determined.
If the diagnosis is Cis and it is noninvasive then BCG is the treatment of choice.
The above describes what would be done by any competent urologist. This is what was done for me ten years ago.
I hope this clarifies the situation for you.
Sara Anne
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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