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Dr. Y.
Dr. Y., Urologist
Category: Urology
Satisfied Customers: 20389
Experience:  Specializing in general urology and reconstructive urology.
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My brother has had bladder cancer for two years treated with

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My brother has had bladder cancer for two years treated with bcg. He had a scan in September and had no feedback when he went for treatment in December. Has been bleeding since then and I persuaded him to bring forward routine appt from April. He had a rigid cystoscope on Tuesday and before this the surgeon made reference to the scan! There was thickening of the left ureter and problems with the kidney and they are dubious about the right kidney. They have told him the left kidney needs removing and asked him if he wants a cystectomy. He has to have various renal function tests and another ct scan. He is very angry that all this was missed in September and is going to complain. Should he change hospitals and is his prognosis terminal?
Submitted: 3 years ago.
Category: Urology
Expert:  Dr. Y. replied 3 years ago.
Hello and thanks for trusting me to help you today. I look forward to working with you.

What was the stage of his cancer initially? Was it T1 or was it superficial bladder cancer?
Customer: replied 3 years ago.
He told me it was superficial and was T3 which was agressive or maybe T1and grade3. He's not quite sure. Every cystoscope he has had since they have found his bladder was very inflamed but no evidence of cancer. Hope this helps
Expert:  Dr. Y. replied 3 years ago.
His cancer would most likely be T1 and grade 3. If he has tumor in the left ureter or kidney, then it probably needs to be removed if it is a high-grade tumor in that kidney. At this point, I do not see anything that looks like this is a terminal diagnosis. Hey cystectomy is an option, but he can continue to receive BCG therapy as well. This can treat a recurrent T-1 tumor in the bladder. But he may still need the kidney removed if there is tumor in the kidney or ureter. If he's not comfortable with his current urologist, then he should seek a second opinion from another urologist. Hope this helps.
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Customer: replied 3 years ago.
What if the right kidney is not functioning properly?
The answer was very helpful. Thank you.
Expert:  Dr. Y. replied 3 years ago.
It all depends on how much function the right kidney actually has. I can't determine this without seeing it. If the right kidney does not have much function, then removal of the left kidney is not a good option. He will need to discuss the kidney function issue with his urologist.
Customer: replied 3 years ago.
Thank you. One more query. Is it normal to have unbearable pain following BCG treatment. He has been having this treatment initially for six weeks once a week then six monthly for three weeks once weekly. He has suffered more and more pain. On the day he has the treatment by the middle of the following night he is in agony. The urologist has said they may halve the dosage next time but he last had treatment in December and he still requires 8 Tramadol a day. Is this normal. Do you have to have three treatments each time or could this be reduced to two. Is there any alternative treatment? I don't know if it is relevant but the original manufacturers of the BCG stopped making it so they had to change manufacturers.
Expert:  Dr. Y. replied 3 years ago.
No, the manufactures do not make a difference. They can cut his dose in half next time. Sometimes, patients do developed severe cystitis from the BCG treatments. If the BCG is not tolerable, one other option is valrubicin. This is available in the United States but I'm not sure if it is available over in the UK. You may want to ask about this option as well.