Kindly check my father's biopsy report and advise the treatment.

Question

Hi doctor,

I am writing on behalf of my father, who is 64 years old. He is a diabetic patient, but his diabetes is completely under control. A few weeks before, he found some blood coming out along with his urine. He consulted a few doctors and went under some tests. He was found to have a tumor in his urinary bladder. His doctor advised him for surgery and biopsy test. His surgery went fine and we have collected his biopsy report. Please share your feedback with us and also advise us our next course of action. Please find the reports attached.

Answer 1

Hi,

Welcome to icliniq.com.

As the biopsy is showing high grade tumor and involves muscularis propria, this makes a T2 stage. The latest guideline suggests a Cisplatin based chemotherapy followed by radical cystectomy (bladder removal).

Pelvic node dissection should be done even if CT scan did not show any regional lymph nodes. Also, whether he is fit to undergo a surgery is the decision of the surgical team.

The choice of chemotherapy is based on general conditions and creatinine clearance. As your father is a diabetic, he should get a 24-hours urine creatinine clearance. If creatinine clearance is normal, then dd-MVAC will be my choice (dose-dense Methotrexate, Vinblastine, Doxorubicin and Cisplatin).

As a basic staging, work up may include CT chest and bone scan. It appears to be fairly early and your father should do well.

For further information consult a medical oncologist online --> https://www.icliniq.com/ask-a-doctor-online/medical-oncologist

Kindly check my father's biopsy report and advise the treatment.

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