High Grade, Transitional Cell, Invasive

High Grade, Transitional Cell, Invasive

My original ocurrence was in 2000. Had a physical, and was having some urinary problems (mostly going too frequently, having some obstruction). Got referred to a urologist. After a couple of months of looking for bladder infections, CT Scans to check for kidney stones, and various cystoscopies, did a biopsy and TURB in June, 2000. Biopsy revealed a surface cancer, non-invasive, which was removed at the time of the biopsy. Did BCG treatments for 6 weeks. Subsequent visits were negative, did a booster set of 3 BCG treatments in early 2001.

During one of my 3 month checkups (cystoscopy in February, 2002), the urologist noticed some “bumps”. He was pretty sure they weren’t cancerous, but he wanted a biopsy to be sure. I hadn’t been having any urinary problems. Also, the various lab work they did on my samples in conjunction with my 3 month checkups was all coming back negative. Shockingly (for the urologist, as well as me), the pathology report came back as high grade, transitional cell, invasive. Resection not really an option, because there aren’t enough surface indicators to show exactly where the tumor is. Also, it’s at the neck of the bladder, which causes additional worry about spreading outside. Did chest X-Rays and CT Scans. Generally, no indications of spreading except for two enlarged lymph nodes in the pelvis. That seemed like cause for worry, but the urologist said that other things could also cause the enlargement, including the biopsy I just had.

After discussing options, I elected to go with two months of chemotherapy, followed by cystectomy and bladder reconstruction. (There’s a study that apparently shows survivability benefits in people who have chemo before the surgery.) Whenever the cancer is invasive, most urologists will always recommend cystectomy.

Anyway, started the chemo April 3, finished May 28. Had CT scans of the chest, lower abdomen and pelvis, and met with the Oncologist June 4. So far, results are positive – CT scans are all clear (the two enlarged lymph nodes are no longer enlarged), and my blood counts are back up to near-normal levels. The oncologist is very pleased with the results and the response to the chemo – he even suggested that we might want to revisit the surgery option, and maybe even do some more chemo treatments. He was going to confer with the urologist on the next steps.

Got a call the same day from the Urologist’s office – they said they had me scheduled for June 24. When I asked if that was for surgery, they said no – it’s an office visit. At this point, I’m assuming that the visit is a pre-surgical consultation, and that I’ll be in surgery in early July, but who knows what he’ll say. I’m taking it as a positive sign that neither doctor feels an urgency to get me into surgery right away.

The odd thing (to me) is that I haven’t been, and am still not having any noticeable urinary problems (no visible blood, no problems going, etc.) If the urologist hadn’t noticed something unusual during the cystoscopy, this might have gone a lot longer before detection.

After all the doctor visits, outpatient surgical visits (biopsy, implantation of a catheter for chemo), oncologists visits, lab visits, and chemo visits, I’m taking the fact that I now have nearly 3 weeks with no treatments or dr. visits as a major cause for celebration – it’s amazing how priorities change.

wmcdowel Author