I am soon to be a 60y/o white male, Family Practice Physician Assistant. I smoked a lot for about 15 years earlier in life, but quit smoking 30 years ago. Outside of being overweight, I have been relatively healthy prior to this.
Original diagnosis was diffuse CIS 2/2013, and I underwent BCG X 6 with minimum side effects. Resection 6/2013 showed continued cancer now high grade T1 disease. I needed a second biopsy in August to determine muscle invasion, yes or no. There was none, but there was granuloma around the left UV junction, so then I underwent treatment with mitomycin X 6.
Mitomycin caused almost UTI-like symptoms part of the way thru treatment, but nothing more. Next biopsy was in 12/2013 and came back with chronic cystitis only, so that was a great Christmas gift to be "cancer-free". But there was significant scarring to the left distal ureter causing hydronephrosis, so I went home with a nephrostomy tube draining my left kidney, which I wore for the next three months.
I went to Fox Chase Cancer Center because my local urologist did not feel comfortable addressing the scarring to the left distal ureter. We performed another cysto with biopsy 2/21/2013 and was found to have recurrent T1 disease on the posterior wall on my bladder.
My cancer has never been very localized to allow for a simple resection of a tumor.
As I have exhausted further therapies we are scheduled for a radical cystectomy/prostatectomy with ileocecal urinary diversion. This is now "scary" stuff as I was led to believe by my local urologist from the start that this was "very" treatable with a significant cure rate.
Fred Brace, PA-C, DFAAPA
Dover, DE
