Hi Everyone
Hoping some of you lovley people can give some advice or share your experience like you have helped me so much previously.
I have used the group prior but just to give an update for my Dad so far! My dad is 73
So he was first diagnosed Sep 19 with low grade non invaisive bladder camcer. He went on to have regular cystoscopy every 3 months and chemo by bladder wash until he finally got a clear result in June of this year.
So the dreaded 3 month check came around in September where they suspected a recurrance as red patches could be seen. This was followed up with rigid cystoscopy with biopsy in October and the results appt was to be given by telephone on 20/11 due to covid! I knew something must not be good when they called 3 days before on 17th and said they were changing the appt to a face to face. So feeling very nervous me and my mam took my dad to his appt to see the specialist nurse. We waited outside of the hospital as at this point we werent told we could have went in with him! So my poor dad faced this alone where they told him his cancer was high grade and the options were 3 years of chemo or complete bladder removal.
So this hit me like i dont know what when my dad told me that in his appt he said he would like to try the chemo 1st, this would be bcg.
I dont want my dad to have anything at all done but in this situation i just want him to be rid of it once and for all.
So the SCN called me and at this point she said i could have been in for his appt after all, this wasnt helpful knowing this afterwards! So after further discussion with my dad he agreed to meet with the surgeon to discuss surgery in more detail. This appt i was told i could attend.
So last Friday we met with the surgeon. He was very approachable and also very direct that the cancer was now very aggressive and that we had to decide between the 2 options. He assured us that the last biopsy showed it has noy yet gone into the muscle. Again my dad said he would like to try the chemo 1st but after asking questions about how this would be monitored he advised he would be scanned every 3 months, however he couldnt guarentee nothing nasty would go on in that time. What he did say was that he didnt want us to be in a situation in a few months time whete he was having to say "sorry there is nothing more we can do for you". This totally devastated me once again and when you here a doctor saying "very aggressive", high risk its terrifying.
So we were not pressured to make any decision at this appt but the surgeon advised that no matter what he decided he needs to have more biopsies taken so they can see any changes since october. So this is booked in for tues 15th under anesthetic. I wouldnt want it any other way but this seems very quick! He said once we have results from this (2 weeks) we can decide from there.
He has also referred him for an urgent ct scan as the last one my dad had was sep 19. Again we didnt know this was supposed to be done every year.
So we are now at this situation and i really need some help on the best way to approach this with my dad. I know it must be his decision and I dont want him to feel pressured but at the same time i dont want the risk of this being undertreated just by chemo without the surgery.
Just to add to this my dad has had a dull ache in his tummy area for a few months now, hes been putting it down to scar tissue from previous procedures and so has his gp. Finally he went back to gp again as this just isnt getting any better so he was referred for an ultra sound which he had today/results on Monday.
I didnt realise the bladder removal was such a big op with a posdible 2 week stay in hospital and 3 months recovery let alone the life changing effects afterwards. They advised they would remove bladder, prostrate, part of the bowel (to make the stoma) and lymph nodes
I know this is a really long post and im very grateful if you have read this to the end!
Im really struggling!
Chemo/bladder removal?
Chance of having bladder removed if chemo doesnt work and my dad being 3 years older for a major op?
Chemo not working?
My dad having to live with a bag but being cancer free?
What is the dull ache?
Has the cancer spread between Oct to now?
Dreading the ct scan?
Is this a lot worse than we think and this is why they are moving on it so quickly?
I have asked him if he would like some support from someone who has already been through this. He is open to it but ideally not online.
Thank you so much for your time! Any replies much appreciated xx
Hi . Sorry to hear your Dad has had a recurrence. I had a different treatment so not in a position to help, but we do have members who have gone either with BCG or RC and I am sure will be along to share experiences. As regards the CT scan. This is normal and as well as giving them a bigger picture, it is also precautionary to rule out anything else going on. Best wishes.
Hi, this choice is a common dilemma - one that I faced 9 years ago age 56.
The choice must be your Dad's, but equally, needs to be a well informed decision. The problem is not knowing if the BCG will cure (about 30% cases) or simply postpone the need for surgery, with the risk of it becoming incurable. The second biopsy & CT scan are to give them a full picture & ensure that they are offering appropriate treatment options.
At this stage, the op should give best chance of cure, but is not a guarantee. They would not offer surgery if they did not think your dad fit enough to manage. It is a major undertaking, but plenty of people his age have had the op & recovered well to live many more active years.
If he is willing, you should talk the options through with him, but try to stay impartial and support whatever he decides. He may have different concerns & priorities. None of us want to see loved ones suffering or undergoing unpleasant procedures, but it is important that they make a free choice, not hindered by any feeling of responsibility to others. Your hosp may be able to put him in touch with another Px to hear their experience.
I chose RC for various reasons, but was able & chose to have neobladder (a reconstruction). Never regretted it as it gave me peace of mind. Was in hosp the minimum 7 nights, no complications. Started resuming activities around 6 weeks post op but took about 8 months to regain full energy & fitness.
Good wishes & feel free to ask any more questions.
It's not possible for everyone & is not an easy choice, compared with stoma & bag. Neobladder initially entails likely incontinence, learning to hold & empty urine, to stretch the neo to a usable size. Training can last months, gardully improving. With a bag you can sleep through the night, but neo has to be emptied at least once. There is also a greater chance of complications with neo. You need an experienced surgeon, but it's worth asking about if keen for surgery but put off by the idea of a bag.
I'm sure someone with a stoma will be along soon to tell you that it's not as bad as people imagine. Whichever diversion you have takes some getting used to, but soon becomes a new normal.
What sort of level of fitness & activities does your dad have now?
Hi Lurea and sorry you finds your self here for your dad. I’ve had bladder cancer for 8 years now, my 18th cystoscope is on Monday. Mine was the same as your dads high grade (grade 3) but a low stage, do you know what stage your dad is? I was given the same choice as your dad either bladder removal or BCG (by the was BCG isn’t chemo it’s an immunotherapy, Bacillus Calmette-Guerin) the chemo is given for a lower grade bc more or less. I decided to try the BCG first as no going back from bladder removal, Your meant to have 3 years worth of BCG which turns out to be 27. I ended up having only 15 as at that time there was a world shortage of it.Both my CNS and myself decided not to start again when they had more BCG, they say now in some hospitals a years worth of it is enough or 15 like I had. I had no problem having it just the usual things tired burning wee,nothing I couldn’t handle and by next day I was fine. My bladders ok now and I have no problems whatsoever, it’s not a problem having a cystoscope ever 6 months (I was more nervous about having the covid test today, in the end that was a piece of cake as well) I was 66 when I had the operation ( no problem there either) but I think I would rely on what the surgeon advises. Just thought I’d let you know there is other hing as well as bladder removal. Very best of luck what ever your dad goes with x
Yes from what I have read so far about the neo it seems its not very straight forward. My dad is 73, 74 in jan, has lived a good healthy life until now! Lives for his allotment and to watch my sons footy! Also fly fishing. He doesnt smoke, enjoys a can but is generally fit xx
Hi Lauren
I went with the Stoma option because I did not want chemo or constant TURBTs. The neobladder was a no-go for me too. On the plus side, I find Basil, my stoma is great to manage. Hope your Dad chooses the best option for him
Best Wishes
Inanna
Hello Innana,
I hope you don't mind me asking. What are "squatters"? Did the cancer become invasive? If not, I am wondering whether the stoma was your choice or if it was suggested.
I'm asking because I was diagnosed with CIS in July 19 non-invasive and was offered BCG, which I went along with. My cystoscopy in November showed that there were no more tumours but there was inflammation, which looked quite extensive to me. I'm having a cystoscopy under GA in February and wondering what choices of treatment, including a stoma, may be offered.
Gandulf.
Please do consider asking if you can give Mitomycin a try. Mr D. had recurrence new tumour straight after his 6 BCG, Consultant said "3 equal options, more BCG, bladder removal or try heated Mitomycin". We were poleaxed as had no idea they might suggest such a massive life changing op so soon. So opted for the Mitomycin. Despite not being able either to tolerate it heated, [so they switched to using it without heating], or keep it in for the suggested time, it has worked well. That was two years ago and he has been clear since, having cystoscopies every 3 or 6 months depending on what it looks like is a minor inconvenience.
Best wishes, Denby
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