Choosing a surgeon...tough decision...

Pat is right, for me the TURB will tell the story, when its over the path report
will tell the tale as to what is to follow for your mom. Ginger

Well Dr. Chang is essentially doing the same thing as Kader is doing...only Chang has set up the surgery in case they do find something. He's doing his own TURB which is great and noone is going to do surgery if it is not necessary. And i guarantee you that Kader would agree with Changs findings and probably vice-versa.
I know when i had my initial TURB locally noone would accept those findings at a major center...but since i had my second TURB done by one of the top guys in the field at Memorial Sloan subsequent top men in the field that i interviewed never questioned pathology.
You have two top doctors here and maybe it boils down to who she likes better or even location.
As for diversions..at 79 you have to take into consideration compliance...though Mom is a young 79...she will get older..and you have to ask which diversion will she be able to deal with or heaven forbid which diversion can someone else deal with? That was one of the things i thought about a lot as my father who was a dynamic intelligent incredible person became unable to care for himself due to a stroke in his early 80's.
Both doctors are recommending a repeat TURB and pathology which is a good thing...one has put her on a surgery schedule in case. He is not going to operate unless it is necessary. How unethical would that be? Schedules get filled quickly in these arenas especially in large medical centers.
Pat

Boy, I think I like the lets look and see rather than remove the bladder just in case. I think the Vanderbilt surgeon and the Wake Forest should have a conference call, this is serious business. You don't want to put your 79 year old mother through this surgery if its not necessary. Like your mom I am confused as well,in saying that the Wake Forest Doctor appeals to me, she can always go back to Vanderbilt, see what the tests say at Wake Forest.
all this input would confuse anyone. Dr.Chang may be okay with speaking to her other doctor so she can be given answers as to why such a be difference in opinions. That would be my advice. On the deversion issue the outside bag would be my choice at her age, simple, conservative, no incontinence. I hope this gets resolved soon, so she can set her sites on the appropriate procedure. Ginger

Mom was told she needs RC (due to CIS which "disappeared" upon diagnosis after first treatment, later recurred and is unresponsive to two cycles of treatment). She consulted Dr. Chang at Vanderbilt (with my dad, not me). He scheduled her for cytoscopy with biopsies of her bladder and kidneys, and scheduled her date for RC surgery. He talked to her briefly, and nurse discussed three types of diversions she could choose. She left confused. However,Vanderbilt is a top hospital, Chang has a fabulous reputation.

Took Mom yesterday to Dr. Kader at Wake Forest (Winston Salem) just so she could talk to another good Urologist. Dr. Kader reviewed her records and found since initial biopsy showing CIS, her local doc bases new diagnosis of CIS recurring on pathology only (wash was "atypical", DNA positive). He says this isn't the time to discuss RC, that he wants to do the cytoscopy/biopsies first, so he knows what's going on. He also wants to get her old slides to "read" himself. He called her local doc and talked with him while we were there (since original CIS biopsy results were missing from records, so he could not even confirm she HAD CIS).

Wake Forest doc said his "team" does around 4 RCs a week, or 8 a month (doesn't add up, I guess it varies). I know Vanderbilt doc does more. Is it normal that surgeons refer to number of RCs done as "we" rather than "I"? Do they operate in a team?

Mom likes conservative, thorough approach of Dr. Kader, Wake Forest. However, Vanderbilt is on US News' top 50 list and Wake Forest didn't make the list. Can anyone advise? She's scheduled for the cytoscopy next Tuesday at Wake Forest, the following Monday at Vanderbilt. She needs to decide asap! She's 79...

Thanks,

Kathleen
Ne Tennessee