Forgot to mention that I was at least pT1 on diagnosis, but there was a strong possibility, based on the histopathology of the initial turbt, that I had muscle invasion. I ended up with 2nd opinions from Vanderbilt Medical Center in Nashville, Tn and MD Anderson in Houston as well as pathology opinions from both of those as well as Johns Hopkins to try to clarify the muscle invasion picture. none agreed on that, so even though treatment recommendations from both MDA and VU were a trial of BCG, I chose to be more aggressive based on the high possibility of muscle invasion and had radical cystoprostatectomy with extended lymph node dissection and neobladder diversion. After the surgery, it was determined that I had pT2a (muscle invasive) bc with no nodal involvement or extension beyond the bladder and no tumor at margins in addition to a Gleason 6/10 multifocal, but small, prostate cancer (previously unsuspected). My post op course was textbook, home on day 6, foley out 3 weeks after discharge and immediate incontinence. Over the next several months I became continent day and night. Returned to work on a very limited basis and a non physically demanding job at weeks post op which was probably too soon for me. Tired easily and needed naps for a few weeks after going back. That was about 2.5 years ago and now I am very physically active for a 61 year old. Ride my bike most days totaling about 100-150 miles/week, lift weights, travel (including trip to Europe this summer) and pretty much do anything I want. I do plan some like fully emptying the neobladder before driving for any long distance, before bike rides and before strenuous physical activity. So the bottom line is that a high quality of life is available after cystectomy. By the way I had no complications post op and have had none since. At last check (June of this year) all tests are ok for bc and prostate ca recurrence so for now in the clear. Best wishes,
jj
