Cystoscopy risks after breast cancer

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I have been referred to urology 2ww haematuria clinic by my GP after having blood in urine ( 2nd time this year) was prescribed antibiotics and only saw blood on one morning. Urine test showed lots of white blood cells and no infection. The earlier occasion an infection was confirmed.

Gp said this referral pathway was quicker than normal urology which is 12months in this area.

Having read up about risk of cystoscopy I am very worried about agreeing to this. My bladder walls are already thin post menopause and treatment with letrozole after breast cancer. I also have a large fibroid which occupies my entire uterus and is pressing down on my bladder( as seen on recent pelvic mri) it's the size of a melon.

I had a grade 3 breast cancer with lympho vascular invasion so am classified as high risk of recurrence. My concerns re cystoscopy are that the invasive procedure will cause inflammation and wake up dormant breast cancer cells, that my thin bladder walls will be damaged, that I will get an infection from the procedure and will suffer over Christmas when I am going away. Lastly if I do have bladder cancer I would be unlikely to accept treatment at my age with no dependants.

Can I refuse this procedure?

  • Hi Tulip29,Welcome.You could refuse but cystoscopy is the standard test to check for abnormalities in the bladder.It’s usual to have a flexible cystoscopy first,it’s a quick procedure it only lasts a few minutes.If anything is found that needs further investigation you go back and have a cystoscopy under general anaesthetic.There is always a risk of infection but this can be treated.Do you have a date for the cystoscopy yet ? Perhaps you could talk to urology beforehand about your worries.Best wishes Jane 

  • Hi Tulip,

    Short answer is I don't know though Imagine nobody will force you to have it. I had a cystoscopy once after blood in urine with no infection. Have never read up about the risks of it and didn't suffer any particular effects. I'll never have another one because they found muscle-invasive bladder cancer so they removed my bladder. I was 69 then (73 now). I haven't got diabetes, not had breast cancer but do have a number of others of your list of ailments, none of which seem to have been much  affected by my cystoscopy, chemo, cystectomy and immunotherapy. 

    Personally I should want to know what is causing the blood, but that is up to you. Also, if it is cancer and remains untreated I should think there would be a lot more blood and pain as time goes on. My mother died of untreatable bladder cancer in 1974 so I have seen some of that. One of the reasons I pushed for diagnosis was that I have a husband and daughter and didn't want them to go through what we did with my mother. 

    Maybe you could talk with your breast CNS? I found my Urology CNS very helpful and still talk to her if I need help or informstion.

    All the best,

    Larestart

  • Thank you both for your replies. I do appreciate you taking the time. Since posting I have had a call from urology to book me a ct scan with contrast as well next week! This has been requ3st3d b6 urology.I am so fed up of hospitals. My gp is very thorough so I can't complain but I feel this is overkill. In the past few weeks I've already had a bone scan with spect, a dexa scan, an mri of my spine, and an mri of my pelvis including the bladder.

  • If they suspect cancer you get some form of scan (s).Hopefully all these scans now will provide information needed for the specialists to decide the best way to help you.I envy you having a thorough gp.Mine couldn’t care less.

  • Blimey, you're having the full set it seems. Sorry to be facetious.  I think I've had most of those during my treatment journey though the bone stuff is at another hospital where they treat my osteoporosis. The CT seems to be the standard one they do before my regular reviews (now 6-monthly) where they check for spread. I think they said that gives the best view so best feedback. Good luck with it next week. I hope it gives them and you a clear way forward and at least they are doing it quickly.

    All the best (and fingers crossed),

    Latestart x

  • Hi  . Sorry to hear you are having to go through this after all you have been through in the past. Good to know you are having a CT scan but a flexible cystoscopy is the best at identifying anything untoward in the bladder. I have had over 20 of these flexi checks over the years with no side effects, although we do hear of the occasional infection. I hope all goes well for you. Best wishes.

    Best wishes to All,   rily.

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  • Thank you rily. The only other woman with breast cancer I know who has had cystoscopy told me it was agony and worse than chemo. At the moment I just want to run away from it all.

  • Hi Tulip, 

    The one I had didn't hurt and chemo was immeasurably worse (and kept happening over 8 sessions) and even then it didn't actually hurt.

    I lay on the bed, bent my knees, the registrar banged something into me - a shock but not painful and asked if I was squeamish and would I like to see what was there - to be honest it was a cross between a verucca and Dennis the menace's hair.

    Men say it hurts a bit because their urethra is longer than a female's. No penis envy here!

    So I hope this reassures you it's bearable. (and I'm quite wimpish.

    All the best

    Latestart

  • Don’t be put off by that experience they shouldn’t be agony.I have had so many I have lost count but none have been that bad.You feel minimal discomfort when the scope goes in.My last flexible one took less than 10 minutes.

  • Hi Tulip29, I've had over 20 too. Absolutely no worries. As always drink loads afterwards. love Hx