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Stage of bladder cancer and how to decide treatment options?

Posts: 3
Joined: Feb 2004

Are there some doctors who are more extreme in their treatment recommendations than others? I would imagine this is true. How do you know who to "go with"? My father supposedly had superficial bladder cancer, had the bacterial treatments twice and was told the cancer cells were gone. A doctor at a second larger hospital has recommended taking out the bladder. This may be because a growth was just discovered in his kidney. That has to come out. The doctor said he might as well have the bladder out now too, since he most likely will have to eventually anyway. That sounds extreme and unconvincing to me. Too effcient. The cancer was not in the muscle of the bladder. Wouldn't they at least try to burn it out first or chemo? The first (more conservative) doctor was very nice and caring. The second doctor has horrible bedside manner but is supposedly very good. Any advice? I think my father should go for a 3rd opinion but I don't want to be too pushy. What is the right thing to do?

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silvergray's picture
Posts: 4
Joined: Dec 2003

I had my bladder and prostrate removed the 12th of Jan,03 because the Cancer had invaded the muscle of the bladder. If your fathers has not invaded the muscle I say keep the bladder as long as you possibly ca, An ostomy bag is no fun at all!!!!!!! I say keep the bladder!!!

Posts: 31
Joined: Mar 2004

My doctor recently removed a bladder tumor only to have it return in six weeks. He suggest I either have a bag or take advantage of one of his specialties which involves using a portion of the intestine to create a new bladder. I understand he is one of the few experts in this process. I like to travel and play golf. Is the bag that much of an problem? Have you ever heard of the second process and the benefits? My e-mail address is chooser@earthlink.net

Posts: 1
Joined: Feb 2004

Please go for a 3rd opinion, then a 4th, then a 5th if you need more info. The more questions you get answered before the surgery, the better. Go to doctors in different hospitals, preferably each opinion from a doctor even more specialized and certified than the one before. Go to a cancer center if possible. I learned from the experience of a friend's father who went for 15 opinions (literally) before he found a doctor that gave an alternate opinion about the cancer and he was able to play tennis for three more decades with the arm that the other 14 were going to amputate. Learning as much as you can about the particular type of cancer is important. Get the official name of the cancer and type it into www.google.com. Please be as assertive as you can to get the doctor to explain why he is not preserving as much as possible. From a friend with transitional cell cancer, I've learned that the sites that this cancer can spread to - the lungs and liver - makes the doctors more conservative and pull as much tissue as possible. But it always pays to get all the info you can, and write questions down to bring to the doctor -- don't leave the doctor's office until all the questions are answered. If the doctor won't give you the information you ask for, find another doctor. Being "pushy" is a lot less painful than surgery. The worst that can happen is that you find out a reason for the more extensive surgery. Best of luck. You have my prayers for your father's speedy recovery no matter what the treatment! Learning to be assertive with health care providers is a life skill that is priceless.

Posts: 1
Joined: Mar 2004

You are correct, there are differences. Memorial Sloan in NYC has the philosophy of always preserving the organs if at all possible. that should be # 1

Posts: 4
Joined: Mar 2004

I'm so sorry to hear of your diagnosis, but let me add my experiece. My fiance was diagnosed with stage 4 BC in July 2002. In Sept, he had surgery and we didn't know going into the surgery whether he'd come out with a bag or a new bladder. We were prepared for an stiomy though. The cancer was muscle invasive, so they removed his bladder, prostate, appendix (because they were there) and 17 lymph nodes. They also removed several feet of instestine & fashioned a new bladder. It's called a neobladder, and was a lot easier to "service" than a bag, and a lot more hygenic. The thing he had to remember was that the bladder was a muscle and he could push to urinate. The intestine is not a muscle, so in order to urinate, he had to press on his lower abdomen to expel the urine. Still easier and cleaner than a bag. The surgeon said the surgery went etremely well and he looked clean, but that they'd test the lymph nodes just to be sure. All 17 of them came back positive. He went through many chemo/rad series, but the cancer had met'd to bone. His femur, chest, spine, clavicle and hips. The choice of the neobladder -vs- the ostomy bag was easy for us because of the appearance, and we were beach people. A bag is hard to hide under swimtrunks. We were very pleased with the results of the neobladder. Unfortunately, his diagnosis was way too late, and he passed away Jan 9th this year. My point is to to a lot of research on the maintenance and servicing of both procedures. Do what's most comfortable for you. Everyone is different, but at least you have a choice! God Bless and good luck.

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