MICHAEL'S JOURNEY

Talked to the doc today. Here is the info:

Michael,

I have reviewed your CT scan.  I left a voicemail on your phone to discuss findings. In brief the CT scan shows that the presumed bladder cancer is larger than I initially thought based on cystoscopy. I suspect this represents disease invading into the muscle wall of the bladder. It also shows an enlarged lymph node within the pelvis concerning for bladder cancer that has spread to the lymph nodes.

The tumor itself is also causing obstruction of urine flow from the right kidney. This explains some worsening kidney function seen on your recent blood work from your preoperative visit.

What this means is that next week when Dr. Tillett goes into resect the tumor he may elect to place what is called a ureteral stent. A ureteral stent is a hollow flexible plastic tube that spans the entire length from the kidney down to the bladder. This will help to unblock that right kidney to improve urinary drainage. It is a temporary measure.

The CT findings also suggest that trying to remove the tumor completely next week may not be possible. Due to the size and likely depth of invasion, the goal for next week would be to get tissue for pathologic diagnosis. 

More than likely we will recommend more invasive surgical management with bladder removal surgery. This is usually performed after giving chemotherapy or immunotherapy for a period of time to help shrink tumor burden and improve overall outcomes.

You are in good hands next week with Dr. Tillett. He does a large amount of our bladder cancer management.

Please feel free to reach out via phone or message with further questions.

Daniel Kaufman, MD

AdventHealth Medical Group Urology Denver