So to recap I was dx in November 2007 with low grade TA cancer, some mixed opinions if I had a recurrence of focal CIS in April 2008. Had 36 BCG treatments since then and all clears. Had CT scan February 2014 which showed ureter wall thickening and the distal ureter.
Ureter cytology wash at that time showed "can't rule out high grade cancer".
Since then had cysto in March, June, October 2014 and January & March 2015 with clear findings and cytology negative plus a negative fish test in October.
Also ureterscopy in March, June 2014 and January and March 2015 shows no visible signs of tumor, however the renal pelvis brushing cytology of 03/12/15 shows again can't rule out high grade cancer.
CT scan shows no change from October 2014 to today, May 12, 2015 with same wall thickening and stranding.
The suggestion is to have my ureter and kidney removed as uro believes with a history of focal CIS in 2008 cancer can be in lining of ureter, thus the findings. Recent cytology is as follows:
1) URINARY WASH: LEFT RENAL PELVIS:
FINAL DIAGNOSIS: ATYPICAL UROTHELIAL CELLS, CANNOT EXCLUDE HIGH-GRADEUROTHELIAL CARCINOMA. SEE NOTE.
URINE CHARACTERISTICS: ATYPICAL TISSUE FRAGMENTS. ACUTE INFLAMMATION.
NOTE: THE CYTOLOGY SLIDE SHOWS NUMEROUS ATYPICAL UROTHELIAL CELLS BOTH IN CLUSTERS AND SINGLY, STRONGLY SUSPICIOUS FOR CARCINOMA.
CLINICAL CORRELATION IS RECOMMENDED. THIS CASE WAS REVIEWED AT THE DAILY INTRADEPARTMENTAL QA CONFERENCE.
I am leaning towards the recommendation as if there is high grade cancer, having it removed provides best chance for a cure. Otherwise every three months wondering over and over again is it back and now aggressive. At least now I know no seen tumor,
Thanks,