Hello again, Eric and Chris,
Thanks, Eric, for your detailed description of what your wife and you have been dealing with. Again, it sounds like you have, or have created for yourselves, excellent medical advice and guidance. You have also given me two more items to look into. I guess I had not encountered the idea of the inner linings of the urinary tract from the ureters through the urethra to be a single, continuous tissue, offering another vehicle for transmission of cancer outside the boundaries of the bladder. It offers yet another concern in the presence of bladder that shows a tendency to produce actively cancerous grade 3 tumors, even if they are only Ta.
Also, your mention of the concerns about handling and mixing interferon (given my overseas location) will warrant some questions. The time hasn't come for that yet, but it's worth looking into now.
Chris, I like your discussion of the micro-metastasis. I made a post in another discussion where I was trying to sort out the issue of stats, individual cases, and the issues at stake. The possibility of micro-metastasis, particularly with a G3 tumor, has the potential of making a mockery of playing the stats game, even if subsequent immunotherapies, cystoscopies, etc., show positive results and no recurrences, suggesting that one's individual case has better odds than the statistical trajectory shows. But, of course, we can't just throw in the towel and throw out our bladders, particularly if a micro-metastasis might make a mockery of that effort also. So, we try to get a comprehensive view of the most relevant and reliable studies, and assess our individual evolving cases against them to help us chart our course.
We also have to take advantage of our doctors' advice, and their experience and judgement in relating our cases against the study results. And while we're doing all of that, we have to try to screen out of all of that our - and even our doctors' - potential biases.
There seem to be a lot of pretty good stories on this forum about people who appear to be successfully fighting off tumors and recurrences and saving their bladders - including a 38-year old whose initial condition, I think, was, if you will, marginally statistically less favorable than yours. So I guess we all hope they make the 3 or 5 year mark, whatever it is, without relapse which might be taken as a cure. Bladder removal has a lot of potential advantages, if the cancer has been contained in the bladder, but it has a lot of potential complications, too. These include certain reproductive and related issues which are generally of greater import the younger one is (although there are solutions to these, also). So, the effort to evaluate what is really at stake in the decision becomes less clear at the same time that it becomes more urgent.
Thanks, Eric, for your detailed response, and for giving me so much to talk with my doctors about. One of my concerns is that, although I have access to a first-class facility and excellent doctors, the medical situation here in Turkey doesn't give me the comfortable feeling or assurance that I have access to a range of expert opinion and/or clinical testing that will be diverse enough to identify and bracket all the issues relevant to my case.
Thank you also, Chris, for your hard-nosed, aggressiveness about developing a frank understanding of the issues in the balance, here, and finding some tools for assessing them.
Chris, I think you said once that you had a clean first quarterly check. Are your doctors doing anything else with you?
I'll have my second TUR in just under 2 weeks. I happened to bump into my doc the other day, and he said, basically, that when he went in, he was going to check the site of the first TUR, and if it looked good, he would take a series of punches for biopsy material throughout the base of the removed G3 tumor. Otherwise, he would scoop off a slice across the whole base, and have that analyzed. I took the "otherwise" situation to mean that he might see the "residual" tumor material that I understand is not uncommon to be found when the removed tumor turns out to be G3.
I'll post the results, and will be interested to hear how your situations are proceeding.
r/
Jim
