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Dr. Andrew Rynne

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Had transurethral resection for bladder tumour. Cystoscopy showing lesion inside diverticulum. What do you recommend?

Answered by
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Dr. Manjunath L Ramarajapalli

OBGYN, Gynecologic Oncology

Practicing since :1984

Answered : 99 Questions

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Posted on Fri, 29 Nov 2013 in Cancer
Question: Have had transurethral resection of large bladder tumor (4cm.) on the 7th of XXXXXXX '13, , Surgeon said; "I got it all". Later received 3 BCGs. Follow -up cystoscopy three months later showed lesion at the level of bladder neck, as well inside of one diverticulum on the right side of the wall. === August 30th. ; Cystoscopy, transurethral resection of bladder tumor for total lesion of less than 2cm., lesion close to the bladder neck on the left side,five biopsy of diverticular lesion taken.=== Pathology results:, Invasive high grade urothelial carcinoma characterized by invasive irregular sheets.Tumor appears to be invading into submucosa, no muscular invasion identified. #2 Bladder biopsy at Neck; invasive high grade urothelial carcinoma with focal papillary arquitecture. The tumor invades into the submucosa and focally into the muscular tissue. Radical surgery is recomended by my MDs,,removal of bladder-prostate,etc..Is there any ALTERNATIVE to try to preserve some quality of life ?? without loosing those Organs ??
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Answered by Dr. Manjunath L Ramarajapalli 43 minutes later
Brief Answer: chemotherapy+radiotherapy can be tried Detailed Answer: Hello, I went through the detailed history of your case. Firstly, MRI abdomen and pelvis should be done for complete staging of the disease. Surgery is usually recommended for disease confined to urinary bladder. In early stage, results with surgery are slightly superior. The other alternative treatment is combination of chemotherapy and radiotherapy. You could probably consider this option. Please do discuss about this with your treating doctor. Good luck
Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. Manjunath L Ramarajapalli 12 hours later
Thank you for your recommendations. Would like to try high dose Vitamin C. IV drip, 50,000mg. + ,per unit as an ---alternative---+ treatment for several weeks, to try to attack the cancer cells and possibly destroy most. I am very concerned about -Chemo/radiation- , side and after affects. Please advise me about the above and your opinion. What "Window" you think this problem of my have,without doing 'nothing' ??? Before [the Stuff] spreads ? Thank you in advance. ---XXXX--- My first fallow up above ,have not received a reply yet, hope you had received it ! If not, please advise and will re-send it. YYYY@YYYY Thanks, ---XXXX---
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Answered by Dr. Manjunath L Ramarajapalli 10 hours later
Brief Answer: Vit-c not useful, wait & watch for some time Detailed Answer: Hello, I am sorry as per my knowledge vitamin C is not a definitive treatment for this disease. You may go ahead with this treatment along with some definitive treatment. I agree with you that there are side and after effects of chemo/radiation. Regarding the chance of spread of the disease, at this stage after some treatment you have undergone, the prognosis appears fairly good without doing nothing. Means the disease is arrested for few years, if not for months) without any further treatment. Good luck.
Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. Manjunath L Ramarajapalli 16 hours later
Thank you kindly for your opinions. !!! On an other note; The availability of Stem Cells and its use for treatment, specially in India & Europe, suggested to entertain its possible use in my case,??!!! ones own 'Medula' harvested and introduced directly into the bladder, during various applications. Would you suggest trying to pursue this type of treatment ? This method is up and coming, or is already being used extensively on the Subcontinent and elsewhere ?!! Could you recommend or direct me to a location where it is being done ? Thank you again and may God bless you in your practice. ---XXXX---
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Answered by Dr. Manjunath L Ramarajapalli 8 hours later
Brief Answer: We dont recommend stem cell treatment Detailed Answer: Hello, we are unaware of clinical use of stem cell in bladder cancer,and I donot recommend it good luck
Above answer was peer-reviewed by : Dr. Shanthi.E
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