Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Hello, My Mother Was Diagnosed With Stage 1 High Grade
Question: Hello,
My mother was diagnosed with stage 1 high grade invasive bladder cancer on July 15th of 2020. i am curious as to how long she may live ass sh is very adamant about not having any treatment done. she also has diabetes 2 and t-cell lymphoma (Mycosis fungoides (HCC) ive copy and pasted reports for your viewing to help answer my questions
SURGICAL PATHOLOGY CASE SUMMARY
MACROSCOPIC SUMMARY
Procedure: Transurethral Resection (TURBT)
Tumor Site: Not specified
MICROSCOPIC SUMMARY
Histologic Type: Papillary urothelial carcinoma, invasive
Histologic Grade: High-grade
Tumor Configuration: Papillary
Muscularis Propria Presence: Muscularis propria (detrusor muscle)
present
Lymphovascular Invasion: Not identified
Tumor Extension: Tumor invades lamina propria (subepithelial
connective tissue)
Clinical Diagnosis and History:
Bladder lesion.
Tissue(s) Submitted:
Bladder biopsy
Gross Description:
Received fresh, container labeled "name removed - bladder tumor," is a
3.5 x 2.4 x 0.8 cm aggregate of granular, gray red, irregular mucosal
tissue pieces. Filtered. All is submitted in three cassettes.
(EJC/ses)
Narrative
Indication: Gross hematuria.
COMPARISON: CT abdomen and pelvis 12/21/2018.
Technique: CT urography. Abdomen CT was performed from the diaphragm to the symphysis pubis with 5 mm collimation without oral contrast and before intravenous contrast. After the uneventful intravenous injection of 100 mL of Omnipaque 350, additional
enhanced scans were performed from the diaphragm to the symphysis pubis with 5 mm collimation during the excretory phase. Coronal and sagittal reformats were also performed.
FINDINGS:
ABDOMEN: There is minimal bibasilar atelectasis. There is degenerative change of the spine, without suspicious focal osseous lesion. The liver, spleen, pancreas, gallbladder, and adrenal glands are within normal limits. The stomach and visualized large
and small bowel within the abdomen are unremarkable. There are no enlarged abdominal lymph nodes. The portal vein and superior mesenteric vein are patent. The abdominal aorta is normal in caliber, with moderate atherosclerosis.
There is a 4 mm nonobstructing calculus within the superior pole of the left kidney. There are no ureteral calculi. The pelvicalyceal systems are normal in appearance, without hydronephrosis or suspicious filling defects. The opacified portions of the
ureters are unremarkable. There are subcentimeter hypodensities of the right kidney that may reflect cysts although are too small to completely characterize. There is no suspicious renal lesion.
Pelvis: There are no distal ureteral or bladder calculi. At the bladder base right of midline there is a 1.0 x 2.6 x 1.3 cm soft tissue density filling defect. The bladder is otherwise unremarkable. There is a moderate amount of stool within the colon.
The large and small bowel within the pelvis are otherwise unremarkable. The appendix is normal. There is no free fluid within the pelvis. There are no enlarged pelvic lymph nodes.
IMPRESSION:
1. 2.6 cm soft tissue density at the bladder base right of midline concerning for a bladder tumor.
2. 4 mm nonobstructing left renal calculus. Unremarkable pelvicalyceal systems and ureters. No suspicious renal lesion. Small probable cysts of the right kidney, too small to completely characterize.
3. Additional incidental findings as noted above
Component Your Value Standard Range
APPEARANCE, UR CLEAR
COLOR, UR YELLOW
SPEC GRAVITY 1.019
1.010 - 1.030
PH, UR 5.5
5.5 - 7.0
PROTEIN, UR 1+ mg/dL
NEG mg/dL
GLUCOSE, UR NEG g/dl
NEG g/dl
KETONES, UR NEG mg/dl
NEG mg/dl
BILIRUBIN, UR NEG
NEG
UROBILINOGEN, UR NEG mg/dl
NEG mg/dl
BLOOD, UR 3+
NEG
NITRITES, UR NEG
NEG
LEUK ESTERASE, UR TRACE
NEG
WBC, UR 4 /hpf
<6 /hpf
RBC, UR 40 /hpf
<3 /hpf
BACTERIA, UR None Seen /hpf
None seen /hpf
SQUAMOUS EPITH, UR 1 /hpf
/hpf
HYALINE CAST, UR None Seen /lpf
<2 /lpf
we are looking for a prognosis on how long she may live also is it possible that all cancer was removed in the turbt that was done
Thanks
My mother was diagnosed with stage 1 high grade invasive bladder cancer on July 15th of 2020. i am curious as to how long she may live ass sh is very adamant about not having any treatment done. she also has diabetes 2 and t-cell lymphoma (Mycosis fungoides (HCC) ive copy and pasted reports for your viewing to help answer my questions
SURGICAL PATHOLOGY CASE SUMMARY
MACROSCOPIC SUMMARY
Procedure: Transurethral Resection (TURBT)
Tumor Site: Not specified
MICROSCOPIC SUMMARY
Histologic Type: Papillary urothelial carcinoma, invasive
Histologic Grade: High-grade
Tumor Configuration: Papillary
Muscularis Propria Presence: Muscularis propria (detrusor muscle)
present
Lymphovascular Invasion: Not identified
Tumor Extension: Tumor invades lamina propria (subepithelial
connective tissue)
Clinical Diagnosis and History:
Bladder lesion.
Tissue(s) Submitted:
Bladder biopsy
Gross Description:
Received fresh, container labeled "name removed - bladder tumor," is a
3.5 x 2.4 x 0.8 cm aggregate of granular, gray red, irregular mucosal
tissue pieces. Filtered. All is submitted in three cassettes.
(EJC/ses)
Narrative
Indication: Gross hematuria.
COMPARISON: CT abdomen and pelvis 12/21/2018.
Technique: CT urography. Abdomen CT was performed from the diaphragm to the symphysis pubis with 5 mm collimation without oral contrast and before intravenous contrast. After the uneventful intravenous injection of 100 mL of Omnipaque 350, additional
enhanced scans were performed from the diaphragm to the symphysis pubis with 5 mm collimation during the excretory phase. Coronal and sagittal reformats were also performed.
FINDINGS:
ABDOMEN: There is minimal bibasilar atelectasis. There is degenerative change of the spine, without suspicious focal osseous lesion. The liver, spleen, pancreas, gallbladder, and adrenal glands are within normal limits. The stomach and visualized large
and small bowel within the abdomen are unremarkable. There are no enlarged abdominal lymph nodes. The portal vein and superior mesenteric vein are patent. The abdominal aorta is normal in caliber, with moderate atherosclerosis.
There is a 4 mm nonobstructing calculus within the superior pole of the left kidney. There are no ureteral calculi. The pelvicalyceal systems are normal in appearance, without hydronephrosis or suspicious filling defects. The opacified portions of the
ureters are unremarkable. There are subcentimeter hypodensities of the right kidney that may reflect cysts although are too small to completely characterize. There is no suspicious renal lesion.
Pelvis: There are no distal ureteral or bladder calculi. At the bladder base right of midline there is a 1.0 x 2.6 x 1.3 cm soft tissue density filling defect. The bladder is otherwise unremarkable. There is a moderate amount of stool within the colon.
The large and small bowel within the pelvis are otherwise unremarkable. The appendix is normal. There is no free fluid within the pelvis. There are no enlarged pelvic lymph nodes.
IMPRESSION:
1. 2.6 cm soft tissue density at the bladder base right of midline concerning for a bladder tumor.
2. 4 mm nonobstructing left renal calculus. Unremarkable pelvicalyceal systems and ureters. No suspicious renal lesion. Small probable cysts of the right kidney, too small to completely characterize.
3. Additional incidental findings as noted above
Component Your Value Standard Range
APPEARANCE, UR CLEAR
COLOR, UR YELLOW
SPEC GRAVITY 1.019
1.010 - 1.030
PH, UR 5.5
5.5 - 7.0
PROTEIN, UR 1+ mg/dL
NEG mg/dL
GLUCOSE, UR NEG g/dl
NEG g/dl
KETONES, UR NEG mg/dl
NEG mg/dl
BILIRUBIN, UR NEG
NEG
UROBILINOGEN, UR NEG mg/dl
NEG mg/dl
BLOOD, UR 3+
NEG
NITRITES, UR NEG
NEG
LEUK ESTERASE, UR TRACE
NEG
WBC, UR 4 /hpf
<6 /hpf
RBC, UR 40 /hpf
<3 /hpf
BACTERIA, UR None Seen /hpf
None seen /hpf
SQUAMOUS EPITH, UR 1 /hpf
/hpf
HYALINE CAST, UR None Seen /lpf
<2 /lpf
we are looking for a prognosis on how long she may live also is it possible that all cancer was removed in the turbt that was done
Thanks
Hello,
My mother was diagnosed with stage 1 high grade invasive bladder cancer on July 15th of 2020. i am curious as to how long she may live ass sh is very adamant about not having any treatment done. she also has diabetes 2 and t-cell lymphoma (Mycosis fungoides (HCC) ive copy and pasted reports for your viewing to help answer my questions
SURGICAL PATHOLOGY CASE SUMMARY
MACROSCOPIC SUMMARY
Procedure: Transurethral Resection (TURBT)
Tumor Site: Not specified
MICROSCOPIC SUMMARY
Histologic Type: Papillary urothelial carcinoma, invasive
Histologic Grade: High-grade
Tumor Configuration: Papillary
Muscularis Propria Presence: Muscularis propria (detrusor muscle)
present
Lymphovascular Invasion: Not identified
Tumor Extension: Tumor invades lamina propria (subepithelial
connective tissue)
Clinical Diagnosis and History:
Bladder lesion.
Tissue(s) Submitted:
Bladder biopsy
Gross Description:
Received fresh, container labeled "name removed - bladder tumor," is a
3.5 x 2.4 x 0.8 cm aggregate of granular, gray red, irregular mucosal
tissue pieces. Filtered. All is submitted in three cassettes.
(EJC/ses)
Narrative
Indication: Gross hematuria.
COMPARISON: CT abdomen and pelvis 12/21/2018.
Technique: CT urography. Abdomen CT was performed from the diaphragm to the symphysis pubis with 5 mm collimation without oral contrast and before intravenous contrast. After the uneventful intravenous injection of 100 mL of Omnipaque 350, additional
enhanced scans were performed from the diaphragm to the symphysis pubis with 5 mm collimation during the excretory phase. Coronal and sagittal reformats were also performed.
FINDINGS:
ABDOMEN: There is minimal bibasilar atelectasis. There is degenerative change of the spine, without suspicious focal osseous lesion. The liver, spleen, pancreas, gallbladder, and adrenal glands are within normal limits. The stomach and visualized large
and small bowel within the abdomen are unremarkable. There are no enlarged abdominal lymph nodes. The portal vein and superior mesenteric vein are patent. The abdominal aorta is normal in caliber, with moderate atherosclerosis.
There is a 4 mm nonobstructing calculus within the superior pole of the left kidney. There are no ureteral calculi. The pelvicalyceal systems are normal in appearance, without hydronephrosis or suspicious filling defects. The opacified portions of the
ureters are unremarkable. There are subcentimeter hypodensities of the right kidney that may reflect cysts although are too small to completely characterize. There is no suspicious renal lesion.
Pelvis: There are no distal ureteral or bladder calculi. At the bladder base right of midline there is a 1.0 x 2.6 x 1.3 cm soft tissue density filling defect. The bladder is otherwise unremarkable. There is a moderate amount of stool within the colon.
The large and small bowel within the pelvis are otherwise unremarkable. The appendix is normal. There is no free fluid within the pelvis. There are no enlarged pelvic lymph nodes.
IMPRESSION:
1. 2.6 cm soft tissue density at the bladder base right of midline concerning for a bladder tumor.
2. 4 mm nonobstructing left renal calculus. Unremarkable pelvicalyceal systems and ureters. No suspicious renal lesion. Small probable cysts of the right kidney, too small to completely characterize.
3. Additional incidental findings as noted above
Component Your Value Standard Range
APPEARANCE, UR CLEAR
COLOR, UR YELLOW
SPEC GRAVITY 1.019
1.010 - 1.030
PH, UR 5.5
5.5 - 7.0
PROTEIN, UR 1+ mg/dL
NEG mg/dL
GLUCOSE, UR NEG g/dl
NEG g/dl
KETONES, UR NEG mg/dl
NEG mg/dl
BILIRUBIN, UR NEG
NEG
UROBILINOGEN, UR NEG mg/dl
NEG mg/dl
BLOOD, UR 3+
NEG
NITRITES, UR NEG
NEG
LEUK ESTERASE, UR TRACE
NEG
WBC, UR 4 /hpf
<6 /hpf
RBC, UR 40 /hpf
<3 /hpf
BACTERIA, UR None Seen /hpf
None seen /hpf
SQUAMOUS EPITH, UR 1 /hpf
/hpf
HYALINE CAST, UR None Seen /lpf
<2 /lpf
we are looking for a prognosis on how long she may live also is it possible that all cancer was removed in the turbt that was done
Thanks
My mother was diagnosed with stage 1 high grade invasive bladder cancer on July 15th of 2020. i am curious as to how long she may live ass sh is very adamant about not having any treatment done. she also has diabetes 2 and t-cell lymphoma (Mycosis fungoides (HCC) ive copy and pasted reports for your viewing to help answer my questions
SURGICAL PATHOLOGY CASE SUMMARY
MACROSCOPIC SUMMARY
Procedure: Transurethral Resection (TURBT)
Tumor Site: Not specified
MICROSCOPIC SUMMARY
Histologic Type: Papillary urothelial carcinoma, invasive
Histologic Grade: High-grade
Tumor Configuration: Papillary
Muscularis Propria Presence: Muscularis propria (detrusor muscle)
present
Lymphovascular Invasion: Not identified
Tumor Extension: Tumor invades lamina propria (subepithelial
connective tissue)
Clinical Diagnosis and History:
Bladder lesion.
Tissue(s) Submitted:
Bladder biopsy
Gross Description:
Received fresh, container labeled "name removed - bladder tumor," is a
3.5 x 2.4 x 0.8 cm aggregate of granular, gray red, irregular mucosal
tissue pieces. Filtered. All is submitted in three cassettes.
(EJC/ses)
Narrative
Indication: Gross hematuria.
COMPARISON: CT abdomen and pelvis 12/21/2018.
Technique: CT urography. Abdomen CT was performed from the diaphragm to the symphysis pubis with 5 mm collimation without oral contrast and before intravenous contrast. After the uneventful intravenous injection of 100 mL of Omnipaque 350, additional
enhanced scans were performed from the diaphragm to the symphysis pubis with 5 mm collimation during the excretory phase. Coronal and sagittal reformats were also performed.
FINDINGS:
ABDOMEN: There is minimal bibasilar atelectasis. There is degenerative change of the spine, without suspicious focal osseous lesion. The liver, spleen, pancreas, gallbladder, and adrenal glands are within normal limits. The stomach and visualized large
and small bowel within the abdomen are unremarkable. There are no enlarged abdominal lymph nodes. The portal vein and superior mesenteric vein are patent. The abdominal aorta is normal in caliber, with moderate atherosclerosis.
There is a 4 mm nonobstructing calculus within the superior pole of the left kidney. There are no ureteral calculi. The pelvicalyceal systems are normal in appearance, without hydronephrosis or suspicious filling defects. The opacified portions of the
ureters are unremarkable. There are subcentimeter hypodensities of the right kidney that may reflect cysts although are too small to completely characterize. There is no suspicious renal lesion.
Pelvis: There are no distal ureteral or bladder calculi. At the bladder base right of midline there is a 1.0 x 2.6 x 1.3 cm soft tissue density filling defect. The bladder is otherwise unremarkable. There is a moderate amount of stool within the colon.
The large and small bowel within the pelvis are otherwise unremarkable. The appendix is normal. There is no free fluid within the pelvis. There are no enlarged pelvic lymph nodes.
IMPRESSION:
1. 2.6 cm soft tissue density at the bladder base right of midline concerning for a bladder tumor.
2. 4 mm nonobstructing left renal calculus. Unremarkable pelvicalyceal systems and ureters. No suspicious renal lesion. Small probable cysts of the right kidney, too small to completely characterize.
3. Additional incidental findings as noted above
Component Your Value Standard Range
APPEARANCE, UR CLEAR
COLOR, UR YELLOW
SPEC GRAVITY 1.019
1.010 - 1.030
PH, UR 5.5
5.5 - 7.0
PROTEIN, UR 1+ mg/dL
NEG mg/dL
GLUCOSE, UR NEG g/dl
NEG g/dl
KETONES, UR NEG mg/dl
NEG mg/dl
BILIRUBIN, UR NEG
NEG
UROBILINOGEN, UR NEG mg/dl
NEG mg/dl
BLOOD, UR 3+
NEG
NITRITES, UR NEG
NEG
LEUK ESTERASE, UR TRACE
NEG
WBC, UR 4 /hpf
<6 /hpf
RBC, UR 40 /hpf
<3 /hpf
BACTERIA, UR None Seen /hpf
None seen /hpf
SQUAMOUS EPITH, UR 1 /hpf
/hpf
HYALINE CAST, UR None Seen /lpf
<2 /lpf
we are looking for a prognosis on how long she may live also is it possible that all cancer was removed in the turbt that was done
Thanks
Brief Answer:
Difficult to say
Detailed Answer:
Hi Tledtke,
It is difficult to say from the pathology report. The fact that it is invasive means that there is some risk of residual cancer cells. However, as no lymphovascular invasion is seen and the CT scan looks normal suggests that your mother is cured. It would however be important to know, if all the cancer was respected, and this is typically also something the pathologist mentions in the report.
Hope this helps. Please let me know if you have further questions.
Difficult to say
Detailed Answer:
Hi Tledtke,
It is difficult to say from the pathology report. The fact that it is invasive means that there is some risk of residual cancer cells. However, as no lymphovascular invasion is seen and the CT scan looks normal suggests that your mother is cured. It would however be important to know, if all the cancer was respected, and this is typically also something the pathologist mentions in the report.
Hope this helps. Please let me know if you have further questions.
Above answer was peer-reviewed by :
Dr. Kampana
Brief Answer:
Difficult to say
Detailed Answer:
Hi Tledtke,
It is difficult to say from the pathology report. The fact that it is invasive means that there is some risk of residual cancer cells. However, as no lymphovascular invasion is seen and the CT scan looks normal suggests that your mother is cured. It would however be important to know, if all the cancer was respected, and this is typically also something the pathologist mentions in the report.
Hope this helps. Please let me know if you have further questions.
Difficult to say
Detailed Answer:
Hi Tledtke,
It is difficult to say from the pathology report. The fact that it is invasive means that there is some risk of residual cancer cells. However, as no lymphovascular invasion is seen and the CT scan looks normal suggests that your mother is cured. It would however be important to know, if all the cancer was respected, and this is typically also something the pathologist mentions in the report.
Hope this helps. Please let me know if you have further questions.
Above answer was peer-reviewed by :
Dr. Kampana
Ok set the urine analysis was done first , then the ct scan then the turbt was done. She is refusing the second turbt and any other treatment as the bcg is not for her being that she is on 20 milligrams of prednisone for the lymphoma. So what are the chances that all cancer was removed in the single turbt that was performed. And why would her urologist say with out treatment she is looking at 12-24 months to live . This very frustrating as we can’t seem to get concrete answers and feel very overwhelmed with this . Thank you for your time
Ok set the urine analysis was done first , then the ct scan then the turbt was done. She is refusing the second turbt and any other treatment as the bcg is not for her being that she is on 20 milligrams of prednisone for the lymphoma. So what are the chances that all cancer was removed in the single turbt that was performed. And why would her urologist say with out treatment she is looking at 12-24 months to live . This very frustrating as we can’t seem to get concrete answers and feel very overwhelmed with this . Thank you for your time
DIAGNOSIS:
BLADDER, TRANSURETHRAL RESECTION:
- HIGH-GRADE PAPILLARY UROTHELIAL CARCINOMA, INVADING INTO LAMINA
PROPRIA
- DETRUSOR MUSCLE IS PRESENT AND UNINVOLVED BY CARCINOMA
- PLEASE SEE SURGICAL PATHOLOGY CASE SUMMARY
This is the diagnosis
BLADDER, TRANSURETHRAL RESECTION:
- HIGH-GRADE PAPILLARY UROTHELIAL CARCINOMA, INVADING INTO LAMINA
PROPRIA
- DETRUSOR MUSCLE IS PRESENT AND UNINVOLVED BY CARCINOMA
- PLEASE SEE SURGICAL PATHOLOGY CASE SUMMARY
This is the diagnosis
DIAGNOSIS:
BLADDER, TRANSURETHRAL RESECTION:
- HIGH-GRADE PAPILLARY UROTHELIAL CARCINOMA, INVADING INTO LAMINA
PROPRIA
- DETRUSOR MUSCLE IS PRESENT AND UNINVOLVED BY CARCINOMA
- PLEASE SEE SURGICAL PATHOLOGY CASE SUMMARY
This is the diagnosis
BLADDER, TRANSURETHRAL RESECTION:
- HIGH-GRADE PAPILLARY UROTHELIAL CARCINOMA, INVADING INTO LAMINA
PROPRIA
- DETRUSOR MUSCLE IS PRESENT AND UNINVOLVED BY CARCINOMA
- PLEASE SEE SURGICAL PATHOLOGY CASE SUMMARY
This is the diagnosis
Brief Answer:
12 to 24 months left is unjustified
Detailed Answer:
Hi again,
Although it certainly is cancer, and further treatment with BCG or similar is advised. However, to say that she only has 1 to 2 years left to live is not justifed based on the pathology report.
12 to 24 months left is unjustified
Detailed Answer:
Hi again,
Although it certainly is cancer, and further treatment with BCG or similar is advised. However, to say that she only has 1 to 2 years left to live is not justifed based on the pathology report.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
12 to 24 months left is unjustified
Detailed Answer:
Hi again,
Although it certainly is cancer, and further treatment with BCG or similar is advised. However, to say that she only has 1 to 2 years left to live is not justifed based on the pathology report.
12 to 24 months left is unjustified
Detailed Answer:
Hi again,
Although it certainly is cancer, and further treatment with BCG or similar is advised. However, to say that she only has 1 to 2 years left to live is not justifed based on the pathology report.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
