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Old 07-27-2012, 12:05 PM   #1
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Questions about TA stage & BCG treatment for bladder cancer

I've been diagnosed with bladder cancer. Doctor removed a cancerous growth in the bladder but the cancer had not gone into the muscle wall. The doctor said it's the TA stage and was caught early. She wants to do the BCG treatment which I understand is a drug introduced into the bladder and held for 2 hours to be done for 6 weeks in a row. My questions to anyone are:
#1. What does TA stage mean
#2. Has anyone had a BCG treatment - what is it like and what side effects you had
#3. Are there better options out there besides BCG?
Many thanks.

 
Old 07-28-2012, 07:21 PM   #2
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Re: Questions about TA stage & BCG treatment for bladder cancer

My understanding is that TA's are papillary cancers on the inner surface of the bladder, and are usually non-invasive. However, they can invade the lamina propria, which is a layer of the bladder between the surface cells and the muscle wall. That's where the numbers come in on the staging system, i.e. Ta1, Ta2, etc.

However, grade is very important, too, in bladder cancer. A Ta, grade I or II is low-grade, and those tend not to recur that much. A Ta III or IV is high grade, and those tend to not only recur often, but to be more aggressive when they do occur. Also if the stage is more than simply Ta (like Ta1, 2, or 3) it would be more likely to need treatment in addition to the surgery.

I looked into BCG wash when my tumor was removed, but as it turned out to be low-grade TA (TA, grade II), it was determined that I didn't need it. The alternative to the BCG wash is a chemotherapy called methotrexate, which is introduced directly into the bladder. Both treatments are uncomfortable, from what I gathered, but the BCG wash seems to be more effective.

My feeling is that it is far better to be uncomfortable, even miserable, for a short time than to end up losing your bladder or, worse, your life to cancer. So if it were me, I'd opt for the BCG.

Ruth

Two-time cancer survivor: CUP in 2001, treated with surgery, chemo and radiation, and Bladder CA in 2005, treated with surgery.

Last edited by SamQKitty; 07-28-2012 at 07:22 PM.

 
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Old 08-02-2012, 05:37 PM   #3
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Re: Questions about TA stage & BCG treatment for bladder cancer

Thanks for your response. I held answering you until I went back to the dr. for consultation yesterday. The cancer removed was a TA and I donít know the grade; however, I have the pathology report and it said non-invasive papillary urothelial carcinoma, low-grade. By the way, congrats on surviving cancer twice! The dr. gave me the choice of BCG treatment or do nothing. The BCG will be 6 treatments, then return in 3 mos. for 3 more treatments, and keep returning every 3 mos for 3 treatments for three years. I asked if her patients could tolerate 3 years of BCG and she said only the most hardy and determined. She said anytime I want to quit BCG because of unpleasant side effects I can. The second choice was do nothing but return every 3 mos for the rest of my life for checkups to see if any cancer returned. If it did, then back to surgery. Have you heard, or I could google this, what the success rate is for BCG treatments? I guess it depends on the grade of cancer. She said BCG is the most used and has shown to help stopping reoccurrence although no guarantees are ever given to a person. I have to make up my mind by the end of August. Iím so grateful for this healthboard website where I can talk to people like you.

Sandy

 
Old 08-04-2012, 10:56 AM   #4
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Re: Questions about TA stage & BCG treatment for bladder cancer

Well, since the pathology report said yours was low grade ("I have the pathology report and it said non-invasive papillary urothelial carcinoma, low-grade") I'm not sure you even need BCG treatments. However, if they're only giving two grades (low and high), you may want to have the slides looked at by another pathologist, just to be sure it's low grade.

If you don't have BCG treatment, the usual procedure is to have a cystoscopy every 3 months for the first year. If there are no recurrences, then you can cut back to either twice a year or 3 times a year for the next year or two, after that you just need a cystoscopy once a year. If you make it for several years with no recurrences, then it's likely that it won't even recur. I still have cystoscopies once a year, but it's been 7 years already with no recurrences and I did not have any treatment other than the initial surgery. I'm really wondering why your doctor is pushing BCG if your cancer was totally non-invasive (which it was) and it was low grade.

Ruth

Last edited by SamQKitty; 08-04-2012 at 10:58 AM.

 
Old 08-04-2012, 03:10 PM   #5
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Re: Questions about TA stage & BCG treatment for bladder cancer

Thanks for writing back. My doctor isn't pushing BCG necessarily as she told me I have the choice of BCG or not. She told me when cancer is cut out that there can always be microscopic cancer cells left behind which no doctor can see in a surgery. That statement right there made me want to do BCG even though I'm afraid of it. I am getting a second opinion but won't see that doctor until Aug 27. I thought of having another pathologist look at the slides, but how do you find a pathologist, and how does one retrieve the slides?

Sandy

 
Old 08-04-2012, 04:20 PM   #6
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Re: Questions about TA stage & BCG treatment for bladder cancer

Call the doctor's office where you're getting the second opinion andask them aif they can have their pathologist also take a second look. Then ask them how to get your slides from the place where you had the surgery to the 2nd opinion pathologist. They'll usually either tell you how to do it or they'll do it themselves.

Admittedly, I went through this over 7 years ago, but at the time hardly anyone was treating Ta's, non-invasive, with BCG, even if they were high grade. You might want to see if you can find out more about the current thinking on this. Don't know if you can access the Journal of Urology (probably not directly) but you can do a search on Bladder Cancer TA, low grade treatment and see what you come up with.

While it's true that microscopic cells can be missed, that's why you have cysctoscopies every 3 months for the first year or two. That way they wouldn't have time to become invasive, and they'd spot another TA during the cystoscopy. I will say that if I ever had a recurrence, then I would definitely do the BCG treatment. But, as I said, I was Grade II and have had no recurrences for 7 years.

Ruth

 
Old 08-06-2012, 11:26 AM   #7
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Re: Questions about TA stage & BCG treatment for bladder cancer

I'll let the second opinion doctor determine if he feels I should have a second pathologist look at the slides. I'm working on questions to ask him when I see him on Aug 27. Your last post raised two questions in my mind that I can ask him so I'm adding them to my list. I'm glad to talk to you and will let you know what I find out from him the end of this month.

Sandy

 
Old 08-06-2012, 04:24 PM   #8
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Re: Questions about TA stage & BCG treatment for bladder cancer

Good luck, Sandy and yes, do keep me posted.

Ruth

 
Old 08-07-2012, 07:58 AM   #9
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Re: Questions about TA stage & BCG treatment for bladder cancer

I had BCG treatments after my surgery for non-invasive bladder cancer and then had the 6 rounds of it and it made me want to go to the bathroom a lot so they gave me pills for people who have incontinence and it calmed the bladder somewhat but for the first few days it was uncomfortable to go places. But this happened in 2009 and I have finished treatments and have had 2 year cystoscopes and everything has been clean as a whistle. Thank God. I had breast cancer in 2001 and had chemo and radiation so I didn't want to fool with anymore cancer cells or no treatment. I am thankful it was caught early. Best wishes to you and for your decisions.

 
Old 08-07-2012, 07:22 PM   #10
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Re: Questions about TA stage & BCG treatment for bladder cancer

Thanks for your encouraging post. After reading so much on the internet, and on cancer blogs and the healthboard, your head starts swimming. I'm more than ready to talk to the second opinion doctor later this month. I'm so glad for you that you beat cancer twice. If I read your post correctly, you had the initial six BCG treatments and then no more after that, is that right?

Sandy

 
Old 08-08-2012, 05:46 AM   #11
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Re: Questions about TA stage & BCG treatment for bladder cancer

Yes, only 6 BCG treatments and then cytoscope every six months and now once a year. It was very manageable. Better than chemo for breast cancer. Best wishes.

 
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