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How Serious is this Pathology Report

7 years 2 weeks ago #42693 by Alan
I would still lobby for the second TURB for 2 reasons. Tumors are often inderstaged but, also to verify it hasn't entered the muscle. Who knows, getting all could be the end of it? Uncomfortable, yes! Excuciating no! For most that I have seen on this subject. There are lots of pain meds and it usually is needed for no more than a day. That second opinion at a major center is where I wouold be headed to if possible. You do have difficult parameters that no one can anser as we aren't in your shoes but, this disease is beatable if treated. God bless!

DX 5/6/2008 TAG3 papillary tumor .5 CM in size. 2 TURBS followed by 6 instillations of BCG weekly with a second round of 6 after a 6 week wait.

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7 years 2 weeks ago #42692 by hipressr
Thanks for the info. The surgeon said he was only able to get 1/4 of the tumor during the turb as it was too big and she was under a good deal of discomfort.

Hoping she regains her strength so another turb can be done....

Does anyone have any thoughts on pathology and direction?

Thanks....

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7 years 2 weeks ago - 7 years 2 weeks ago #42691 by Alan
Sorry to read about your Mom's diagnosis but, you are at a good place to try and get answers. There are many that are smarter than me and I don't check here much amymore but, I see that I am the only one reading right now.

If I am reading correctly the tumor is grade 3 meaning aggressive or high grade but, it hasn't gone the muscle (non invasive). For which most say and do spare the bladder. With your Mom's frailness and Parkinson's that adds a few more parameters also. If she is up to it the TURB (transurethal re-section) isn't a long surgery-usually 20-45 minutes. My wife, a nurse, says procedue but when they are cutting on me it is surgery! At least that gives you a chance of killing and beating it off right there. BCG can be difficult but, very effective and many tolerate it well. Maybe give a chance one treatment at a time? No one says you have to do 6 etc. As many on this board will say, a second opinion may be also in order. Preferably at a center that has sub specialists that all they do is bladder cancer in their department. Sloan Kettering, MD Anderson for example. Where are do you live? Perhaps another will have a good hospital to get that 2nd opinion!

DX 5/6/2008 TAG3 papillary tumor .5 CM in size. 2 TURBS followed by 6 instillations of BCG weekly with a second round of 6 after a 6 week wait.

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7 years 2 weeks ago - 7 years 2 weeks ago #42690 by hipressr
Hi All,

I feel your pain as my mom was recently diagnosed with bladder cancer. I have given her as much support as possible in the last weeks.

We just received the pathology report samples they took from the TurbT. Here are the details:

-75 year old female (my mom)
-papillary urethelial carcinoma high-grade(WHO)
-abundant necrotic tissue and blood clots
-no invasive neoplasia

-Specimen consists of multiple fragments of brown hemorrhagic blood clots mixes with multiple grey white possibly necrotic tissue measuring in aggregate 4 x 2.4 x 0.5 inches.

The urologists told us she is not a good candidate for removal of bladder, she has parkinsons and is somewhat frail. They would like to reduce the bleeding with some light radiation and build up her strength so she MAYBE she will be a candidate for for a TURBT at some point but no BCG as she could not handle it and the tumor is too large. Uro also said it is a grade 3 PTA tumor which i do not see in the report.

They say they do not know how long she has but maybe 1-2 years, but they were reluctant to say. Not sure what to think any more, would like some more opinions, will get another uro to look at info, however thought some of you all might provide some helpful input.

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