G3T1 with Squamous Differentiation?

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Hi Folks

My first OP appointment ~2 weeks ago gave the news of  multifocal G3T1 with potential squamous differentiation which was a little unexpected. The flexible cystoscopy showed 3 small (<10mm) smooth lumps with a few capillaries wafting on the surface. Didn't look that scary, but this shows that looks can be very deceiving!

OP options given by consultant were BCG or Cystectomy, with heavy leaning towards the latter. I have another TURBT booked next week and can't wait to get the pathology results on this and choose treatment path. Although I said that I would prefer to conserve the bladder with BCG at the appointment, further reading is pushing me towards cystectomy with ileal conduit. Was offered neobladder as I am "young (63 next week) and fit (albeit the big belly)" but at the moment I would prefer things as simple as possible, with quickest recovery so leaning towards conduit.

Anybody had this or similar diagnosis, and if so, what was your choice, and considerations to get there .. and comments on how it went please, including recovery time?

I fully understand that we are all unique / different and make our own decisions, so no right or wrong answers. The decision I make will be solely mine, and I don't look back to regret my decisions as they were all right for the time that I made them.

Thank you

  • Hi Pegasus, I love that you sound so positive, its very uplifting. I am waiting for the nurse to ring me with appointments and she said it will possibly be in the next 3weeks. They are so lovely and i feel very lucky to have such a nice team. I will defo keep in touch and let you know how it affects me. much love to you Angela

    Much love Angela x

  • Hi Tortoise,Good to hear you have made a decision.Did you learn much more about the squamous cell ? 6-8 weeks seems to be about the wait for the surgery judging from this board.They have to get a team together and make sure they is a bed on intensive care/high dependency straight afterwards.I had mine a month after meeting the surgeon but he put me on the urgent list.Best wishes Jane 

  • Squamous cell was in the cytology report, but not definitive as it was a suggestion of SD focus in the report. Playing safe with RC.

    Likely going for stoma (ileal conduit) as one of the blighters was in the Trigone so although Neobladder is an option, maybe not ideal, and I want to get back to normal asap.

  • I think you have made a good decision if Squamous cells have been found.I had a solid tumour which was mostly removed during a TURBT but had grown back by the time of cystectomy.You should adjust well to having a stoma if you have one.I had to be able to change the bag unaided before I was allowed home.Plenty of advice and support here regarding the surgery and what to expect.Best wishes Jane 

  • Glad you made a decision let me know how you get on or feel the need to chat

  • Met surgeon today and  surgeon preferred preservation over surgery in my case. Had prepared myself for RC but now going with BCG with option for RC if it doesn't work. In the meantime, i am upping exercise level and working to  lose weight (BMI 32) just in case RC required.

    Now ready to push for BCG to start asap.

  • Fingers crossed.BlushFingers crossed

    It doesn't matter where you go, there you are
  • That is great news, please let me know when you start it all. Here’s hoping no side effects and it works like a dream. I will keep you in my thoughts. 
    janine 

  • Interesting that surgeon expressed a preference. I wonder if you could have hd your way if you wanted surgery? Anyway, hope all goes well for you.

  • Hi Tortoise , the very best of luck to you. I start my BCG 6 week induction on August 22nd. I cant say I am looking forward to it, I do have concerns about side effects etc, but if it does the job of course I will be over the moon. Its a long road we are on , and I am sure it will be scary at times. It sounds like you had prepared yourself for RC ? how do you feel about the BCG ? much love Angela x

    Much love Angela x