Superficial BC vs. Metastatic BC

Rosemary,

There are lots of people that are members of this website that have had cystectomies for T1 tumors.. Its just playing the statistical odds.  Statistically if you have had recurrent, multiple t1 or G3 tumors (especially with CIS) chances are much higher that you will have progression/metastasis.  There have been many studies done that have shown a higher survival rate if the bladder is removed immediately upon diagnosis of "superficial" invasive disease (i.e. T1 tumors that invade into the lamina propria).  These T1 tumors have shown their ability to invade and quite a few doctors would recommend bladder removal.

Its sort of a preventative measure... If you know you have a 50-75% chance of progressing over the next 5 years, your best chance of survival would be to remove the bladder - even though you may have a 25-50% chance of never having progression/metastasis. Its a balance between life and quality of life. As I understand it I personally have about a 10-15% chance of progression or mets over the next 4 years (according to the EORTC statistics). I am willing to play those odds even though if I removed my bladder it would improve my odds of long term survival (albeit not by much).

I personally like the bladder sparing treatment protocols, as I feel I am not quite in a high enough risk zone to warrant giving up my bladder.. I do however remember a fellow on this website who had a very similar diagnosis to mine (we were diagnosed within a month or so of each other) with two T1G3 tumors, he had a neobladder with 3-4 months.  I think his user name was KC Northstar.

I guess it also comes down to the definition of "superficial"... quite a few doctors don't like including T1 or G3 tumors in the "superficial" category, since they do have a tendency to have much worse outcomes than Ta low grade disease.

I happened on this most uncommonly excellent treatise on Superficial Bladder Cancer while googling around for a concise definition of "Superficial" BC.  I highly recommend this rather short but thorough report for anyone with BC.  I couldn't find a date on it however.

Written by Dr. William Oosterlinck
Chairman, Superficial Bladder Cancer Committee,
European Organisation for Research and Treatment of Cancer (EORTC)

www.touchbriefings.com/pdf/26/ept032_r_32_oosterlink.pdf

Rosemary

Thanks for sharing that Chris. just for the sake of discussion....

Why would patients with T1 superficial disease have a cystectomy?  Would "no apparent invasion" mean no apparent invasion of the lymph nodes?  I'm thinking that if they had a cystectomy, then there would have been muscle invasion, which would be T2 or higher?

Just curious...

Your friend,
Rosemary

"I guess I am just wondering if superficial bladder cancer can metastisize?"

Bladder cancer can also spread through the bloodstream. Cancer cells gain access to distant organs via the bloodstream and the tumors that arise from cells' travel to other organs are called metastases. Cancers of the bladder generally spread locally or to lymph nodes before spreading distantly through the bloodstream, though this is not always the case. If spread through the bloodstream does occur, the lungs and bones are the most common sites to be involved.
cancer.med.upenn.edu/types/article.cfm?c=21&s=66&ss=768&id=9464

There are even a small percentage of cystectomy patients with confirmed T1 "Superficial" disease that end up with micro-metastasis months or years after their bladder has been removed with no apparent invasion.

(Someone asked me to make this subject into a thread of it's own.  The entire thread can be read under the topic  "Mom just had TURB and I have questions"

I didn't want to move these replies from out of that thread as they seemed to be a part of the natural flow there.  Also, it seemed that the following replies got mis-posted in Londongurl's thread.  I know it's confusing.  It's confusing to me.  If this correction is a mis-step, please someone put me right.)  

I am re posting these here for further discussion or comment under it's own heading...
Kim
Rosemary
Londongurl
Rosemary