Suggestion those with superficial non invasive

16 years 6 months ago #9402 by wsilberstein
Replied by wsilberstein on topic Suggestion those with superficial non invasive
I've often tried to figure out what made my situation different from those who've had lots of recurrences. Perhaps my surgeon skillfully reamed out my bladder (too bad I had to leave him for not dealing with my urethral stricture). It wasn't BCG since I never had any. My urologist treated me with 8 instillations of Mitomycin C (which led to my strcture). According to my understanding of current protocols that would NOT be the way to go for CIS and G3.
Perhaps my CIS was not very CIS-like. I only had one focus, and they didn't find it on the slides they reviewed at Harvard. But there was universal agreement that my presentation was high grade.

-Warren
TaG3 + CIS 12/2000. TURB + Mitomycin C (No BCG)
Urethral stricture, urethroplasty 10/2009
CIS 11/2010 treated with BCG. CIS 5/2012 treated with BCG/interferon
T1G3 1/2013. Radical Cystectomy 3/5/2013, No invasive cancer. CIS in right ureter.
Incontinent. AUS implant 2/2014. AUS explant 5/2014
Pediatrician

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16 years 6 months ago #9395 by mznoregrets
Replied by mznoregrets on topic Suggestion those with superficial non invasive
Hi Zach,

I haven't posted much to you, however I have benefitted numerous times having read various postings of yours. This being another.

You perspectives are very helpful in this case. And it is something I think everyone could greatly benefit from - chosing for ourselves what we expose ourselves to and realizing we are each responsible for what we chose to take in. That is difficult concept for some folks at times. Even though I have been careful to post my questions in the invasive cancer/cystectomy sections, I have been pressured by someone who deals with non-invasive BC to NOT make such a posting as it was disturbing for that person. I did not chose to start a war over it, nor am I chosing to at this time, but I am longer going to feel bad I am posting in the appropriate sections for my disease. This website is here to help me too even tho I had invasive BC instead of superficial BC.
Can you imagine going to a restraunt for dinner and getting angry the menu has something on it for anyone who is hungry ? Well, this website has solid info and a great forum for anyone dealing with whatever stage, type or person dealing with BC. And that does include me, too.
Thanks for the post and ponderings. Hopefully we can all get along better for it.
God Bless, Holly

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16 years 6 months ago #9391 by timb
Superficial and invasive are separated but there IS crossover. which I think is part of the above problem. As you illustrate, Connie, another compliaction is the different approaches advocated by different surgeons. I guess they have a hard job weighing up the risks and some err too hard on the side of caution. I guess it depends on what type of person you are as a doctor to an extent. the key ingredient is being happy whatever you decide. I trusted my surgeon and am lucky to be happy with the outcome so far.

all the best

tim

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16 years 6 months ago #9389 by ConnieOnAQuest
Replied by ConnieOnAQuest on topic Suggestion those with superficial non invasive
I was initially diagnosed with Ta G1 in 1998, recurrence of Ta G2 in 2000. Then I was cancer-free for 7 years. The cancer returned as high grade (still, as it turned out, only in the lining) in July 2007. At that point I thought it prudent to consult with one of the big teaching hospitals. At my first consultation, the urological oncologist said the words "take out your bladder" four times in the first 15 minutes. Each time I felt a painful pang of anxiety. He was not recommending it immediately, of course, but talking about what he would do down the line. I saw no reason for him to shake me up with those words at that time. (The tumors were very small, had been removed, and there was no CIS). Why would he keep repeating that phrase, if not to scare the patient? Before him, the thought of cystectomy had never occurred to me. I would have preferred to keep it that way unless/until invasion occurred, and, of course, it is more likely not to invade than to do so. Needless to say, I was very displeased with that doctor, and moved on.

On this site, superficial and invasive posts are separated for good reason. Each of us is free to choose what we think will be helpful to read and leave the rest. I have recently read a little in the invasive section, in very small steps. I'm walking a fine line, balancing satisfying my curiosity with trying to curb my anxiety about worst-case scenarios.

Connie

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16 years 6 months ago #9388 by timb
dmartin

statistics are great and formed the basis for my decisions. but there are sooo many! i've read squillions. and, in keeping with the theme of this thread, you can choose pretty much which ones you choose to go with. there are a lot of other factors too which never get mentioned like were these people smokers, what did they eat, where did they live? were they happy or sad? what's their family medical history like? do they take drugs? that said, I'm relieved to report that my CIS was multifocal ;)

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16 years 6 months ago #9387 by dmartin12358
Replied by dmartin12358 on topic Suggestion those with superficial non invasive

7 years w/ no recurrence is great!!

Studies confirm that BCG certainly delays 5-year recurrence rates. Also that recurrence occurs more often within the first 5 years.

One study of 61 patients with superficial blc (and 72% of these also had CIS) showed that the odds are about 53% for progression over 8 years (whether treated w/ BCG or not).

FYI, studies have shown that CIS occurs in multiple forms. One form (that is focal) seems to have a progession rate as low as 8% in patients followed over 16 years. Other forms (diffuse or multifocal) that are associated with T1 have much higher rates of recurrence/progression.

Dx 7/04, CIS + T1G3, Age 50
2 TURBTs
12 BCGs
Cystectomy 8/05 USC/Norris
So far, so good (kow)

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