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While I have been signed up to BCC and have followed the site since I was diagnosed with BC in June this year (Ta High Grade) I have not been in the discussion forum except as a reader. I believe that BCC is a wonderful resource principally because of the many caring people who contribute to it and who respond to the questions and fears expressed by others.
I am now at a stage when I would appreciate comments from others who may have experienced what I am now dealing with. After my diagnosis of Ta G3 I had a TURB followed by the 6 weeks of BCG with which, thankfully,I had no problems. Recently I had a followup cysto which my urologist advised disclosed red spots but no new tumors. He was not more specific about the characteristics of the red spots. I think he suspected they were caused by irritation or inflammation due to the procedures. However, he had a urine cytology done which has reported no malignant cells, a lot of acute inflammation cells and a few chronic inflammation cells.
From my research on the subject of “red spots” it appears they may indeed be indicative of inflammation but also can indicate incipient CIS or dysplasia. Coupled with the range of possibilities, I have been unsure about the degree of accuracy of the cytology and whether, despite negative report from both the cysto and the cytology, I should pursue with the doctor the advisability of a biopsy now which I believe will provide a more dependable diagnosis. My alternative is to await my next cysto which is scheduled in three months from the most recent one. My thanks to anyone who can offer any advice based on their knowledge or experience.Hi Ken. Back in the days when I was having TURBTs and BCG and chemo treatments intravesically, I had several occasions where I had red spots which again were described to me as inflammation. When I first went in for a cystoscopy my whole bladder was raw and red. Certainly a common finding. In my case it was simply inflammation. When I finally got my bladder out, there was a large area of CIS however when they did the pathology. Clearly the biopsy is the most comprehensive test, but the doc may not want to do it yet. It seems a lot of this a a wait and see situation. Any high grade BC is worrisome, even at Ta stage. Worthy chat with your URL and make sure you’ve got a top uro at a major cancer centre. Don’t mess around at outskirt locations .
All the best. Keep us posted.
GregHi Ken
I had 30 BCG treatments between 2006 and 2009. I had red spots appear on the bladder wall during my last 18 treatments. My Uro did mention that he suspected the spots were inflammation from the BCG treatments. He did biopsies twice during this time frame and thankfully they were all negative. He explained to me why the biopsies were necessary in his opinion, which was possible CIS. If you are concerned I would recommend you have your Uro do a biopsy before your next cysto. If you prefer to wait until the next cysto and they are still there, I would ask your Uro to take a biopsy during the cysto. Better to be safe and keep the thoughts of CIS out of your mind.
All the best,
JackCraig also had occasional red spots found during Cysto’s between BCG treatments. Did urine tests and checked for infection too. Biopsy’d the first time, then did a wiat and see, followed by another Biopsy on the second. Both were negative. His URO is very conservative/cautious.
So waiting till next cysto, if that’s not too far out, might not be bad, but you do want to have a plan and know what it is.
Especially, as you have surely read over and over, you need to have extreme confidence in your doctor.
Jackie
When I had BCG treatments I always got those red spots and they were always irritations. I had the same thing when I was on Valstar infusions. And sometimes dehydration will cause that. But as always, they should be checked out. Good luck to you. I think if I ever open a hotel I will name it the red spot hotel. Well, it’s just a thought. I know, Greg, not a very good thought. But just think of the marketing!
I was fortunate in that I only had one faint red spot after my first 6 weeks of BCG. My uro wasn’t concerned about it and said that it should be gone by the next cysto in 3 months and it was. My suggestion is to make a follow up office appointment with your uro to discuss this in more detail. If he feels that it is truly inflammation rather than CIS ask how he knows. He may have some experience in telling the difference. He could also recommend that you move up your cysto appoint to about 6 weeks from now versus 3 months. If it is true inflammation it should have cleared up by then. If not then I think a biopsy would be a good idea to double check for CIS. A lot of this depends on how you feel about your uro. If you are confident in him than you could follow this route, if not I suggest push for a biospy or consider getting a second opinion.
Lots of red spots while I was in treatment, they lasted for a couple of years actually. Now they are all healed.
Hope that is all yours are ,too. I wouldn’t worry too much unless there are other symptoms accompanying the redness…blood, atypical cells that increase, or other things.My uro wasn’t concerned,,,just kept an eye on them.
Hugs and good health , Jeanne
My profound thanks to all of you who offered advice. It is most helpful to have the benefit of your experience and it’s so kind of you to take the time to write. I think I’ll take it a step at a time and begin with a meeting with my uro to discuss the situation before pushing for a change in the program. Ken
Well, with the benefit of the comments by all those who responded to me, I decided to schedule a visit with my URO to address my concerns about the potential that the red spots were incipient CIS and that maybe a biopsy was advisable. His response was that while the cystology which was done at the time of the last cystoscopy did not disclose any malignant cells and was quite effective in revealing CIS that to allay my concern he would schedule the next cystoscopy for Dec.3 ( 5 weeks earlier than now planned ) and would adopt the procedure involving anaesthetics so, if found necessary, biopsies could be done at the same time. This was totally responsive to my concerns. I was pleased to find that he was not dogmatic or rigid in his approach and was sensitive to patient concerns. I remain hopeful that this next procedure, which will occur in about 2 1/2 weeks will confirm that the red spots were indeed inflammation. Thanks to all of you who prompted me to take charge of the issue.
Good on you Ken for being proactive, and good on your Uro for listening and being so open minded.
All the best,
JackI’m glad to hear that your uro actually listened to your concerns. That to me is the sign of a realy good doctor. Now we will just pray for an all clear.
Glad to hear it, Ken. It’s great your doctor was receptive to your concerns and great you took the initiative to approach him. Now we’re praying for inflammation – seems rather strange, but all things considered it’s good. Of course, maybe he’ll find no spots at all and that would be better still! Happy for you.
GregThat’s great news Ken & like the others I’m happy to hear your urologist is addressing your concerns. Fingers crossed for an “all clear” & so glad he was able to move you up the list so your worry time is shorter. Thinking good thoughts for you.
FloThank you all for weighing in for me. It’s wonderful having you at my back. I remain optimistic that the favourable conclusions from the last cysto and cytology were correct and that this cautionary procedure on Dec. 3 will not reveal any contrary information. I will post the results of the biopsy when I have them. Bless you all. Ken
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