After chemo/presurgery questions

I had gotten done my chemo on 4/20 and had my surgery on 6/20. I asked my surgeon why so long he said you are good up to 90 days with the chemo and also he had a heavy schedule and also that maybe it be a nice break for me I could not agree more, man I was wiped out so I got some time to enjoy my family. It was nice my B'day was June 8 and Fathers Day and my youngest sons B'day so it worked out great for me. Marcus you will be ok my friend. Joe

hi marcus - sounds like you have all your ducks in a row. it would be hard to switch doctors at this point, so it's good you're somewhere that you feel comfortable.

this is not the time to be shy - ask your doc exactly how many RC's he's done. the quality of your surgeon is key to your outcome.

the newest thing seems to be to do the chemo first, thereby shrinking the tumors as much as possible, which gives you about a 10-15% better survival rate. so it's great you went thru the chemo. my husband is finishing up 3 cycles of cisplatin/gemzar. he's had what he describes as "stomach pain" for the entire time. he says it feels like he took advil on an empty stomach. apparently the chemo relaxes the sphincter muscle that is (i think) above the stomach, so you get the pain from all the reflux. anyway, his last chemo is next monday oct. 22nd, then he has a week off, then the RC on nov. 5th. he has stage T-2, T-3. so we are right behind you on the surgery schedule. too bad you're not going to hopkins - we could commiserate! after your surgery they will give you the pathology report and you will know whether you will need more chemo. hopefully it will have worked and the path report will be negative. i'm wondering why they waited to do your surgery 8 plus weeks after you finished your chemo? the whole point of doing the chemo first is to shrink the tumors, then do the surgery before the tumors have a chance to grow back. anyway, best of luck to you. we all know what you're going through. we check this forum every day, so please keep us informed during your surgery and recovery. i hope your significant other is bringing a laptop with to the hospital to keep us informed. that's what i'm going to do during my husband's surgery.

eileen, mike g's wife

Marcus,

Sounds like you have good Doctors there in Tucson. My father lived in Saddlebrook for many years, until he died 2 years ago at a hospice off Orange grove.
I spent 8 weeks there with him after open heart, then in rehab at Health South , my memories of him are there in the mountains and the beautiful evening skies.
My dads step daughter and her husband are Dana and Ira Adler, in Tuscon.
Anyway back to bladder cancer, my husbands r/c was Sept, 14, in Aug, he had nite sweats, abdominal pains as well., it was after 2 turps, maybe just a side effect of the situation. He had no sign of cancer elsewhere, just in the bladder and muscle. Stage 3 T-2.. Path report the same after surgery, no chemo , no radiation needed.
He did the outside bag, didn't want to cath or be doing flushing etc. with the neo bladder. He is 66. We don't mind the bag at all, its easy.
Good luck with your surgery, I will be there in January, my dads wife lives in a assisted living behind Northwest Hospital on La Cholla. We stay at the El Conquistador, love the grounds, its beautiful. We like to eat at the Wildflower on Oracle, living in Cleveland January is better somewhere else, like Tuscon.

Ginger Beane

Hello all and many thanks for quick replies.
My doctor is mcdonald in tucson, operation at TMC. He's done many r/c's has worked with a partner for many years. I laughed when my surgery date became Halloween day. Just the best time for a little carving on the old pumpkin. anyway,I had b/c diagonsed after a turp in May and then had 3 1/2 rounds of gemz, cisplatin, and taxol over the summer. CT scan 3 weeks ago showed no spread according to rad. report. doc will operate either w/ or w/o lymph node involvment. do i insiste he dig deep and take all possible nodes? best practice is CT/Pet scan? chemo wasn't a breeze, but thanks to medicine-magic of emend, I came back up strongly and quickly. I have only have felt differently this week, with night sweats and dull adom. ache. thanks to all for this info and ideas. you meet the most sincere people when life gets serious. thanks again.
marcus

Dear Marcus,

Although your abdominal pain could be something totally benign such as stress, gas, chemo side effects, and the night sweats could also be related to chemo after-effects, you and your doctor should probably do a scan to see where you stand now after chemo. This is pretty standard in your situation, and the newer PET/CT combo is good for staging post-chemo. I hope you have access to the latest and greatest technology at the institution you go to.

I was under the impression that you need to be sure chemo worked before going in for surgery, even a partial response is good enough to qualify you for a cystectomy with curative intent. On the other hand (worst case) sometimes a uro will not do surgery if there any distant spread, or even lymph node involvement; other surgeons will operate in the presence of lymph node involvement (and remove them). What is the opinion of your doctor in this situation?

There is always the option of more chemo if the first rounds didn't work well enough, so long as you are strong, in good general health and can take it- I know some people really cave under chemo while many others seem to almost breeze through it. I hope you're one of the latter!

All the best to you,
Wendy

Marcus,
Your in the right place. Lots of knowledge on this forum. My questions to you are these, where are you, what facility are you choosing for surgery, and how many opinions did you get. ??? ONE THING ALL ON THIS FORUM AGREES ON IS THAT FOR THIS SURGERY YOU NEED QUALIFIED SURGEONS WHO HAVE DONE MANY OF THESE SURGERYS. The answers will give us a little more to work with. Many on this forum have metastsized bladder cancer, as much info that you can provide will help us dearly.

Ginger Beane