I am s/p RLL lobectomy for Stage 1 Adenocarcinoma (BAC) and s/p hysterectomy and vaginal radiation for stage 2 endometrial CA. On my 2 yr. follow-up CT, a small enhancing nodule anterior bladder wall suspicious for transitional cell cancer was found. I am trying to educate myself before I see the urologist and I have been reading the NCCN guidelines. I am uncertain about one point that I hope someone can help me with this.
When there is a suspicious bladder lesion a cystoscopy with biopsy is performed for staging. If there is non-invasive disease, a TURBT is done. If the tumor is cTa low grade, then consideration is given for a single dose of intravesical immunotherapy/chemotherapy. My understanding is that this single dose is given out of concern for seeding of cancer cells from the tumor excision. My question concerns the seeding concept. Why isn’t there concern about seeding when the bladder biopsy is done?
I have one other question. I live on the east coast close to Baltimore. I plan on seeing someone at Johns Hopkins but the head of the JH bladder clinic is leaving and the other bladder specialist is not doing bladder biopsies. I will be consulting with an urologist (my gyn-onc surgeon’s recommendation) at JH whose specialty is prostate cancer (he does do bladder biopsies). I anticipate wanting to get a get second opinion if the pathology is positive for cancer.
Any recommendations for urologists who has a specialty in bladder cancer either at the Cleveland Clinic or some other major medical center on the east coast?