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I’ve just read a very interesting article in the UCLA Newsroom that bears on the situation of a lot of us . I’d post a link if I knew how ( so I’m a Digiphobic Luddite !) but the title is ” Quality of biopsy directly linked to survival of patients with bladder cancer ” I’ve just had a 2nd TURBT in 3 weeks and it sounds like they have hit on the reason . All too often not enough care is taken to obtain samples of the muscle underlying the tumours . As all treatment depends upon the results of these biopsies our urologists will have to become much more aware of providing quality samples . Too much is riding on this and can affect all of us .
I looked into the story you posted.
I think you meant this one:I had 2 initial TURBTs as well.
I was given a first TURBT on July 22, 2015. Despite the Pathology showing that the tumor was non-invasive (i.e. Ta) the Urologist nevetheless wanted to do a re-TUR.
I had my second TUR on August 25th (no “BT” here because the “B”ladder “T”umor was removed during the first TURBT) . I wanted to know why? I asked my Urologist. He said that it is standard practice now. OK, So, being the Engineer I am, I consulted the “Canadian Urology Association Journal” (i.e. CUAJ) to find out.Here is the document I found:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812001/pdf/cuaj-1-56.pdf
from McGill University, Montreal “Update on the management of non-muscle invasive bladder cancer”It covers the need for, and benefit of, a Second TURBT – Namely:
” …This will help to remove all residual tumours, improve
accuracy of staging, improve response to BCG therapy,
reduce the frequency of recurrence, and potentially delay
tumour progression. ”Not Bad, Eh ?
May God Bless,
DDep
That all makes sense . Mine was because the tissue samples were inadequate to allow proper staging etc . And yes , a few more tumours were found and removed . So far as I’m concerned this could have been all avoided if the previous procedure had been more carefully done with an eye to providing proper samples and thoroughness. The third procedure was done at the request of one of the top people here and even though he does the cystectomies for him removal is the last option not the first . The lesson here is to get a 2nd opinion if there is the least bit of doubt.
I may add …
Thank God for Organizations such a “Bladder Cancer Canada”, this website and, more importantly, the opportunity to discuss our concerns with all the great people here.
DDep
This is the very reason I always recommend patients get a copy of their pathology report. The lab analysis will indicate the quality of the sample received from the surgery.This critical to insure the staging is accurate.
If the lab reports T1 then it is also recommended to do 2nd Turbt even if their was muscle in the original sample. This is standard protocol at major cancer centres and teaching hospitals in both Canada and USA.
Thanks guys for the post and the links to this information.Hello
Interesting. Each of my surgeries muscle was taken in the sample. Actually caused major delays in the pathology reports because there was so much tissue sample to go through. The last report the pathologist even complimented on the amount of tissue included in the sample. This is very reassuring to me.
What is not so reassuring is the 2nd TURBT protocol. Not done in my situation. Will be speaking to my uro on this. As a side note, none of the tumor recurrences have been in the same place as previous ones.
Krbeave (Rick if I remember correctly): I had a hunch that in your situation something wasn’t done right and the medical people knew it thus pushed yours through. This would have ended up being to your advantage instead of poor work just being covered up and forgot about. I have a gazillion family members and several friends in the medical professional and shop talk between them does bring up errors and downright ineptitude of some medical people and how often other medical people have to step in and try to rectify the situation.
Take care
Both recent TURBT’s were done on an urgent wait list so they were both done on weekends when the on-call urologist could fit me in and a bed opened up . i’m not assigning blame to anybody but when things get hurried sometimes shit happens . Not any more . I have become very pro-active and assertive when dealing with the doctors . Not rude or aggressive but if I don’t advocate for myself nobody will . When I am reassembling an engine if it will take an extra few minutes to do it right I will take the time . Do it once and do it right , my customers deserve nothing less . My problem is that I also expect things that I have fixed to stay fixed . That doesn’t apply to this disease but that expectation has been so ingrained into me that it’s hard to not expect it .
Hello krbeave
I agree. IF your first TURBT was messed up and not done right, can pretty much guarantee that the urologist(s) were aware of this. As a result, the usual reaction is to be sure it is done right the next time because of human compassion or the possibility that your whole case will come under scrutiny in the future and they don’t want any kaka coming back at them. Either way, it works to your advantage.
So, in the end, don’t stress. You have probably now received really, really good medical care. FYI: in the family debates, the belief that you get better medical care in Alberta vs Saskatchewan is winning.
Take care
Hi Cheryl .
The urologist who is in charge of my case now ( not the guys who did actual TURBT’s ) really gives me confidence that I’ve found the right physician . Including my very first procedure which was 18 months ago I have passed through the hands of 5 different urologists which , although I understand the reason why , isn’t conducive to good continuity of care . I intend to stick with this doctor and allow him the overall responsibility of my care .
I guess that I can’t help but stress , I have a much too vivid imagination ! But I’m working on stress management .
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