Dad Diagnosed with S2 High grade MIBC Recently

[MEC]

Hello all,

My father was recently diagnosed with High Grade MIBC. I apologize if this is not in the proper forum. He initially had blood in urine and they though his prostate was enlarged but they found a mass pushing against the bladder and did state to him it might be bladder cancer. They performed a TURP and literally turned it into a TURBT and removed the mass. The Urologist stated they got “all of it”. Pathology came back as MIBC stage 2. He is now going for a CT scan of the chest. Is that a normal procedure? Just wondering what next steps would be? treatment? He is leaning towards bladder preservation as that was an option given to him. Thanks for any and all advice and words of wisdom.

[Nightingale]

Hi MEC,

It is difficult to say for sure because each patient is different and has different issues.  In my case, my urologist wanted to check my kidneys even though I had non-invasive, low grade BC.  I am now an 11 year survivor and no longer have any treatments, but I was glad he checked my kidneys to ensure nothing ‘funny’ was going on with them.

In your dad’s case they may be basing their decision on a whole host of things, such as family history, or results that from their test that is making them double check other parts of his body.  It’s very difficult to say.

What I can tell you, is that is is absolutely ok to ask the doctors ‘why’…why are they checking these areas.  The doctors should be willing to provide an explanation, or you have the right to get a second opinion.

I hope this helps a bit.  The good news is that they caught it and removed the mass.  Now to preserve the bladder – good that they indicated to you, that is an option.

My Best,

[DerekA]

Hello MEC,

Sorry to hear your dad’s news. It is a very difficult and distressing time for your dad, you and family. All is so new and confusing. But to give you a hopeful possible outcome, I was diagnosed with T2 high grade MIBC nearly 5 years ago. Doctors said that I was a good candidate for bladder preservation, so that is the procedure that I followed. I’m still here, with a perfectly performing bladder, and in good health.

I have an extensive blog under “DerekA” that will tell in (too much) detail, what Trimodal Therapy involves. Also if you would like to talk with me, you can do so through Bladder Cancer Canada “One2One Peer Support”

Telephone 1-866-674-8889

…derek

 

 

 

[Joe]

Hi MEC,

I am glad that you are involved.  It is a daunting experience for your dad, first to be told that he has cancer, then told to choose the removal of the bladder or bladder preservation treatment

CT scan, sometimes plus PET scan are typical diagnosis done for muscle-invasive bladder cancer to check cancer has not spread to lymph nodes and other organs.  According to MOFFIT cancer center in Florida,  common sites of distant bladder cancer metastasis are found in the lung, bone and liver.  I do not know why the doctor has requested CT scan for the chest only.  Perhaps, the cancer was only T2 so the chance of metastasis is low and it may require a longer wait time for PET.

The standard treatment for T2 is the removal of the bladder.   But as Derek mentioned that for a certain patient, bladder preservation  – Trimodal treatment (TMT) (maximum resection of the cancer area, chemotherapy, and local radiation) can give an equivalent overall survival rate without going through the surgery to remove the bladder, hence provides a better quality of life.   I understand that about 1 patient per month, the University of Toronto selects a candidate patient for TMT. Professor Kulkarni of UT lists an ideal candidate for TMT as follows.   1. Tumour size < 5 cm, 2. Single site, 3. No Hydronephrosis, 4) Minimum to no Carcinoma In-situ,5) Good bladder function/capacity 6) Compliant with follow up.  See the presentation by Dr. Kulkarni.

“www.youtube.com/watch?v=YOMfsNe4MBw”

Below is the link to the BCC presentation on radical cystectomy vs bladder preservation

“www.youtube.com/watch?v=253cLtBB29A”

Personally, I know someone who had chosen TMT but cancer metastasized during the treatment.   So, you may want to find out how the doctor is going to detect that TMT is not working early and if radical cystectomy can be done when that happens.

best

[Author]

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