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Bladder Cancer/ Surgery complications

Posted by Nick on May 03, 1999 at 11:38:17
Dear Doctor,
I am a 59 y.old male,nonsmoker. Two months ago I was diagnosed with bladder cancer. Last month (April)I had a cystoscopy transurethral surgery (one 2cm
by 2cm tumor growth and 2 other smaller tumors were removed). I was advised
to return to work the second day following the procedure and to resume normal activity.  So I did.
After 3-4 days I experienced complications and I started to feel weak.
I was admitted in the hospital with an arterial bleeding from the site of
first surgery.  Another cystoscopy transurethral surgery was performed on me
in order to seal the arterial bleeding. I was given NO additional blood to make up for the loose.
The second time around, the same doctor advised me to limit any and all activities to a minimum.
Seven days have passed since my second surgery. I have been resting in bed with very litte activity. How long does it take for the wound to heal in my bladder? When can I resume normal activity?  

The muscle of my bladder was attacked by cancer and the cancer is in the second stage.  What procedure should I have in order to check for metastasis? Any suggestion will be greatly appreciated.
Thank you,
Posted by HFHS M.D.-BE on May 11, 1999 at 09:13:41
Dear Nick,
What you have described is one of the possible complications following transurethral surgery on the bladder. Minimizing activities and some bed rest usually is helpful in decreasing the chances of further bleeding and allowing for healing of the site of tumor resection.  Increasing your fluid intake helps prevent blood clots in the bladder that could potentially cause obstruction to the flow of urine. Healing is variable in different individuals, based on age, extent of surgery, general state of health, the type of medications s/he is taking, etc. I would suspect that after seven days you should be able to gradually return to your normal activities. Remember that you should be in touch with your urologist about this, since he is primarily responsible for you.
As far as checking for the progress of your cancer, which is referred to as staging, in addition to cystoscopy, and transurethral resection, which you have undergone, you could also have the following: chest x-ray, CT scan/MRI, bone scan, and blood tests.  
This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
*keyword: bladder surgery, bleeding
Posted by Nick on May 19, 1999 at 17:24:10
Two weeks ago I went to see my urologist in order to find out the results of my biopsy performed on the tumors following my surgery.The doctor told me that the tumor is a "stage II" transitional cell carcinoma  and that I would have to undergo a cysto procedure every 3 months to watch for reoccurence. He said if it had been a stage III some treatment would required; but since is a stage II no treatment is required at this time.  I asked him to explain how invaded was the muscle in the bladder but he refused to give me an explanation insisting there is absolutelly no cancer invasion. Is this possible? He removed 3 tumors from my bladder.
The report does not mention numbers nor letter after the "stage II".
Absolutelly no treatment was prescribed. No other tests were ordered either.
I am "in shock" and not sure where or what to do.  What is a transitional cell carcinoma "stage II"? Is there any treatment? How invasive is this type of cancer? Does this type of cancer have a high reocurrance?.  What is the prognosis of this disease ?
Thank very much for everything.

Posted by HFHS M.D.-CK on May 20, 1999 at 15:55:33

Dear Nick,
After a bladder tumor is removed transurethrally it is examined microscopically by a pathologist.  The size of the tumor, number of tumors, and shape of the tumors are important in determining further treatment.  However, the stage of the tumor and grade of the tumor are the most important factors.  The stage of the tumor is how invasive the tumor is.  Is it just in the surface lining, the next layer (lamina propria), or into the muscle layer of the bladder. Stage Ta is on the surface, T1 is in the lamina propria, and stage T2 is into muscle etc.  Grade of the tumor is a measure of aggressiveness.  Grade I is slower growing, and grade III grows and invades more rapidly.
Your understanding of your Pathology report and treatment plan is not adequate.  You need to discuss the findings with your physician.  Further monitering may indeed be the treatment of choice.
This information is provided for general medical information purposes only. Please consult  your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available through our department at the Henry Ford Hospital  and its suburban locations (I-800-653-6568).
  * Keyword: bladder cancer, stage, grade

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