Stage and Grade of Tumours etc

I re-read some of my notes today and had quite forgotten one phrase that rattled me which I'll repeat below.

Here is a list of stage and grade from Cancer Research UK

My first diagnosis was G3pT1 with earlier invasion. That's:

G3 - Grade 3 cancers have cells that look very abnormal - they are called 'high grade' or 'poorly differentiated' and are more quickly growing and more likely to spread.

p - I'm not sure if this is papiliary or pathological state

T1 - the cancer has started to grow into the connective tissue beneath the bladder lining.

It was described as "moderate size so it does represent potential risk to him"

That was in August 2006!

By October 2006 I had CIS which is Carcinoma in Situ which is also high grade.

CIS - very early, high grade, cancer cells are detected only in the innermost layer of the bladder lining.

This is when I started BCG Immunotheraphy Treatment. I had 6 rounds of BCG

In May 2007 there was one small area of CIS and I had a further course of 6 BCG instillations.

In November of 2007 I was clear no evidence of malignancy.

I then had 3 maintenance instillations of BCG

In May 2008 I was once again clear no malignancy or CIS and had a further 3 maintenance instillations of BCG.

In total then 18 instillations of BCG.

In January 2009 there was mild Atypia but this could have been caused by the procedure itself - I was told I'd need more maintenance but this was not needed.

In October 2009 I was once again clear and no evidence of malignancy or CIS.

In May 2010 I had a small recurrence which was a G2pTa

G2 - Grade 2 cancers have cells that look more abnormal - they are called 'medium grade' or 'moderately differentiated' and may grow or spread more quickly than low grade

p - as above and

Ta - the cancer is just in the innermost layer of the bladder lining.

I had to go back in a month or so after this and was warned that "if he continues to get recurrences he may require some more invasive treatment in the future". Don't tell me that isn't chilling? Now I've re-read it it surely is but this was written by the Registrar not my Consultant this time :-)

In August 2010 I was clear and could go onto Flexible scopes.

I had a scope in December 2010 which was clear as was my urine cytology. As you may be aware in April 2011 they saw something they didn't like but in June when I had yet another operation nothing was found there at all.

I look back on this lot with amazement - I'll have to map this out somehow to make sense of it all. What I recognise now is quite what a journey I've been on so far. I hope that I continue to remain clear and that I don't get any more recurrences small as they may be :-)