need advice

3 years 6 months ago - 3 years 5 months ago #59956 by Alan
Replied by Alan on topic need advice
Thanks. Heck, I am just a volunteer like the rest of the posters. We are all in the same boat trying to learn and help.

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.

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3 years 6 months ago #59955 by joea73
Replied by joea73 on topic need advice
Hi Alan,

Thanks and especially thank you for not having banned me from the forum yet. :)
Actually, reading everyone's experience and learning about bladder cancer
in front of a PC has been a great mind full activity to forget about my tinnitus
momentarily.

Just let you know that I had gone through the stages of a shock, worry, why me?,
physical and mental anxiety of seeing blood in my urine, cysto, turbt, waiting for
the result as anyone here, though I had not had BCG or any other treatment.
Also, I meet patients in the support group every month who are in different stages
and in different treatments. So, I feel like I am here representing them too. As the media tend to sensationalize cancer or the word of cancer and some industries take advantage of cancer patients' to their products and services, I have thought that Demystifying some confusion points may reduce anxiety. That is why I brought up Mitochondria as I often sugar is bad for cancer in the media and people suddenly change their diet without knowing what is really going inside our body.

Anyway, thank you for running a very welcoming forum for everyone.

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3 years 6 months ago - 3 years 6 months ago #59948 by Alan
Replied by Alan on topic need advice
Hey Joea73,

Glad you are posting frequently! Even though much of the science is over my head, I am learning! I faintly remember studying about "mitochondria" cells years ago in beginning BIO in college and of course I have no retention being a business major, LOL!

Anyway, thanks for being here.

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.

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3 years 6 months ago #59944 by Lin281693
Replied by Lin281693 on topic need advice
thanks again, a lot to absorb

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3 years 6 months ago #59943 by joea73
Replied by joea73 on topic need advice
This might help you to understand easier. This gives you a quantitative comparison if BCG or intravesical chemotherapy (MMC) will improve your recurrence problem.

Open this link. You will see the recurrence risk and progression risk of non-muscle invasive bladder cancer.
This calculator is based on a large study done by European Organisation for Research and Treatment of Cancer.

www.evidencio.com/models/show/1025

Select as below for your case.
Number of tumor : 2 to 7
Tumor size: < 3cm
Primay recurrence rate: > 1 rec /yr
Ta category: Ta
CIS : No
Grade : 1

There is 38% chance that you will have another recurrence within 1 year
There is 62% chance that you will have another recurrence within 5 years
There is 1% chance that your cancer progresses within 1 year
There is 6% chance that your cancer progresses within 5 years

So, based upon your history, you will have 38% chance of recurrence within 1 year.
But there is only 1% chance for progression.

Now the question is how much will BCG and chemotherapy ( or intravesical chemotherapy) reduce recurrence in your case. Since Mitomycin is used often for this type of intravesica chemotherapy according to several studies, Mitomycin. What is the difference in efficacy and side effects between BCG and Mitomycin.

There was another study done in Europe in 2009, involving 2839 patients. 54% was Ta and 43% was Ti. G1 was 58%, G2 16%, G3 7%. Your case is TaG1. I did not get a detail report because it costs $US 35, but the summary of the study says with a median follow-up of 4.4 yrs after BCG and Mitomycin, 43% recurred. Overall there was no difference in the time to first recurrence between BCG and MMC. The link to the study is listed at the end.

So, statistically speaking, you should expect the improvement recurrence from 62% within 5 years to 43% per in the same period if you will have BCG or MMC therapy. It does not mean that you will have 43% in 5 years even after BCG or MMC treatment, but it is rather a yardstick to review what should be the next treatment for you.

Cancers are caused by mutations of multiple genes in DNA. Bladder cancers are known as heterogeneous. There are hundreds of gene mutations have been found in bladder cancers. I recently attended a talk by a scientist who had done a study of genome analysis of non-muscle-invasive bladder cancer. He checked genomic sequence of 80 NMIBC patients and found not two persons had exactly the same combination of gene mutations.
This is one of the reasons why a certain treatment works for some people and does not work for others even though.


www.europeanurology.com/article/S0302-2838(09)00434-5/abstract/an-individual-patient-data-meta-analysis-of-the-long-term-outcome-of-randomised-studies-comparing-intravesical-mitomycin-c-versus-bacillus-calmette-gu-x000e9-rin-for-non-x02013-muscle-invasive-bladder-cancer#%20

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3 years 6 months ago #59937 by Lin281693
Replied by Lin281693 on topic need advice
Thank you, much to think about. Linda

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