tumor recurrences

Artie, You are welcome for refrsshing your memory. I hope others hit that link also as many are not aware of the newest recommendations. I am sure the great majority of us who have had many low grade papillary recurrences resulting in TURB's or fulgerizations are pleased to see the results of the long term tests on patients who had prior 3 and 4 recurrences and treatments eager to pariticipate in the watchful waiting option rather than TURB or sugery presented to them from the innovative urology group at the Univeristy of Miami and also Department of Urology, Hadassah University Medical Center, Jerusalem, Israel. Very impressive and convincing findings resulted from those participants. If you could read the entire story of that testing and surveillance done at University of Miami rather than just reading the abstract, you too would feel confidant (if your b/c historyand recurrences are similiar) to do watchful waiting and spacing your cysto's at longer intervals - as would many others, in my opinion. Rosie

Right! Thanx for refreshing my memory.
I've read this info before and thought it something still in testing stage. Actually, it would be very good for us (to have less fulguration and TURs).
But I would wait until doctors at MSKCC and other major centers assured us this was a viable option. (Personally, after more than eight years of treatment, I feel perfectly safe waiting a few extra months before having fulguration.)

Artie and Hope, watchful waiting is NOT for high grade but for low grade papillary recurrences rather than having immediate TURB or fulgerization. In some cases, depending on the location of the tumor, fulgerization is precluded. Low grade papillary has been shown to grow very slowly almost never becomes invasive. See this link on bladder cancer web cafe under superficial bladder cancer which tells of the long term tests, survelliance and conclusions on watchful waiting and when it is suggested. Also, I have seen many reputable medical personnel encourage mytomycin immediatly after TURB for papillary TCC but BCG for CIS. My urologist has not done the mytomycin either but will when I have my next TURB. blcwebcafe.org/superficialblca.asp

Hi Hope,
First let me address the BCG question. Doctors have found that BCG is not effective in low grade, low stage TCC.
Right now I am on a four month cysto schedule, but becasue I never go more than six months without seeing my urologist, my doctor finds my tumors very early and uses fulguration to burn them out. This procedure (I assume), is safer than a TUR, especially since there is no anesthesia involved.
As for the mitomycin, my doctor did mention it once, but never followed through with it. Honestly, I am not sure why she hasn't tried it and I never remember to ask about it.
You said you are not sure 'about when you do a drug and when to do surgery'. I feel certain they always use some surgical method to remove tumors. The drugs are used to help prevent new tumors from recurring. And again, that is only at certain stages.
"Watchful waitng" seems a fairly broad term. I really think it is meant for higher grade tumors. Sort of ,'let's wait and see before we do a radical cystectomy'.
On the other hand, maybe some folks refer to the standard practice of scheduled cystos to see if a new low grade/stage tumor develops, as 'watchful waiting'.  

hi ALTIE
YOUR INFORMATION WAS GOD SENT THANKS ALOT FOR SHARING
MY QUESTION TO YOU IS ALL THESE 8 YEARS WHY DIDN'T URE UROLOGIST TRY TO INSTILL A DRUG LIKE MITOMYCIN OR BCH ?
BECAUSE I AM VERY CONFUSED ABOUT WHEN TO U ADMINISTER A DRUG
AND WHEN DO U DO JUST SURGERY AND NOW SOME UROLOGISTS DO
WATCH FUL WAITING

I am currently doing watchful waiting monitoring of my present superficial recurrence first seen in February 2006 and again June 2006 rather and rejecting yet another TURB. I now feel confidant spacing the cystoscopies further and further apart and declining surgical intervention. After five years, 4 recurrences and 3 TURB's; information provided initially by Wendy Sheridan; additional research, information and monitoring my own recurrences I am convinced the frequent invasive cystoscopy, surgery and the stated risks involved, post surgical discomfort are more of a threat to my health then my papillary superficial TCC at this time. You can read my story and update on Tales from the Trenches under Rosie. I would be glad to communicate with anyone interested in this approach. Rosie