Adenocarinoma in Bladder

That seems like a logical approach, but with an invasive tumor type, time is always a factor so make sure all those steps happen quickly. It is a good sign that the CT scan did not indicate any involvement of lymph nodes.

Again, ask how many primary bladder adenocarcinomas they have treated. My first uro said he might see one every 10 years. This is a fairly small city without a lot of top medical facilities so I chose to be treated at Vanderbilt although it was 300 miles away.

I looked at the Yale Smilow website and it talks at length about prostate cancer, some reference to kidney cancer, and very little about bladder cancer. It does mention immunotherapy options for bladder cancer (BCG, etc.), but that is not generally considered for these tumors as I believe they explained to you.

Also when you discuss partial cystectomy, ask how many of those they have performed. In bladder cancer surgery, experience and repetition are of utmost importance.

I would still recommend going for a second opinion, preferably to a high-volume bladder cancer center like Memorial-Sloan Kettering in New York or Mass General in Boston, perhaps while waiting for that second TURBT. As another option, you can have the pathology slides sent to Johns Hopkins in Baltimore for a second read on those. I'm sure your head is spinning by now.

I'm certainly not trying to diminish the quality of care of Yale Smilow. I'm sure it is a very good medical facility. Bottom line, your wife and you have to be comfortable and confident in your medical team... wherever that may be. As long as you both feel her needs are being met by the Yale team, then that is where you should be. I'm sure your meeting next week will answer many of the questions you have.

Let us know how your appointment goes next week.

Hello... I'm very sorry to hear about your wife's diagnosis. I know both of you are scared and overwhelmed with information. As Sara Anne said, I was diagnosed with a bladder adenocarcinoma in January 2010. A local uro did the TURBT and as soon as my path report came back, he said right up front that he did not have much experience treating this rare tumor and he referred me immediately to Vanderbilt Medical Center in Nashville. There was no talk of waiting to do a second TURBT. I was at Vanderbilt within 2 weeks.

When I went for my first consult with the Vanderbilt surgeon, he said his recommendation was to do a partial cystectomy which would remove the portion of the bladder around the tumor site. He also said we could "wait and watch" but made sure I understood that cancer cells are like toothpaste... once they are out of the tube you can't put them back in. I opted for the partial cystectomy.

Where is she being treated? Ask how many times they have treated this type of tumor. I am not comfortable with the doctor "thinking" it is localized to the bladder, or waiting to do a second TURBT in a few weeks. These tumors are always invasive. My doctor treated my case with urgency and after he removed the small portion of my bladder, a tiny area of cancer cells was found in the specimen meaning the TURBT had not gotten everything and it had started to invade the muscle layer.

My advice is to get a second opinion as soon as you can, preferably at a major bladder cancer hospital, to see if another experienced uro agrees with your doctor's approach. With bladder cancer, you have to be your own best advocate and push for getting the best treatment possible. Also get a copy of the path report so you know exactly what was found and how they staged the tumor.

I don't mean to scare you more than you already are. It sounds like they caught your wife's early which is very good. Mine was caught fairly early as well, and that was almost six years ago. Please let us know how things develop.

Give your wife my best wishes. I know how it feels to be in those shoes...

One of our members, Catherine, had adenocarcinoma and I am sure you will hear from her. She had a partial cystectomy at Vanderbilt University and is doing great.

Sara Anne