Posted 6/17/2012 6:35 AM (GMT -7)
Yes, Mel, that is the general gist of things as they stand.
Best - surgeon can make it through to bladder, finds nothing suspicious, end of story for now. If he gets in, he will take some bladder wall samples regardless to be examined, and he will take pictures of bladder walls to show current condition. Last time he was in there, Fall of 2010, he said it looked like "a war zone", and that there was complete scarring of the interior from the radiation.
Not so good - he is not surgically able to get through the sealed shut bladder neck to get to the bladder. If it use to scar shut in a months time, he said its hard to know what it's going to be like after nearly 2 years, especially since the bladder, bladder neck, urehtra, haven't been used since the by-pass surgery. There is risk for additional injury if he has a hard time, and a great risk of infection. If he can't get through, this is for nothing, and we would still have no reasonable way to inspect the bladder for cancer. The most normal sympton for bladder cancer is bleeding. But in my case, if I were or am bleeding, there is no way for the blood to exit the bladder since it is sealed off. He said its possible that the increase in my bladder spasms and considering how much more they hurt over time (again with a non working bladder), that it could be getting filled with something, and having no way to exit, is causing the spasms at this time.
Not so good - he can get in, and finds evidence of cancer, he will either have to take samples right then and there, or do a second to remove any cancer through the scope.
Worse case - he sees extensive cancer, and it would require a complete removal of the bladder. Looking at a risky, 8 hour or more surgery, he said high chance of perm. rectal damage, would be hard with the by-pass in place, and due to how merged all the surgical lines would be because of the radiation damage to the area.
Also sucks - if either cancer version came to be, and the cancer or bladder were to be removed, there would be no way to follow up the cancer removal with radiation, which would be the standard of care in that situation. So unless all the cancer were to be removed perfectly, then recurrance without any options for treatment would be the case.
Best bet is for this surgery to be a success on the first try,, and get an all clear on the cancer. How much pain an how long it will take to recover, depens on how hard it is to get through with the surgery. The cath is only going to be there to aid in the healing, and have a way for any blood or whatever to drain. Since the bladder has no input of urine, there won't be even the normal way to flush it out, i..e. drinking fluids, as they will never hit the bladder on its way out.
There is a lot riding on this, as the odds for finding something are high, and both my main doctors feel this is a sensible way to find out, and its not based on needless fear.
Age: 59, 56 dx, PSA: 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, original catheters 63 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/10 .04, 8/10 .06, 2/11 1.24, 4/11 3.81, 6/11 5.8, 12/11 14.0, 4/12 37.0
Other: Spent total of 1 ½ years on 21 catheters, had Ileal Conduit Surgery 9/10
Member of Prostate Cancer & Chronic Pain HW Communities