Bladder cancer diagnosis, should I see another doctor?!


Question: Bladder cancer diagnosis, should I see another doctor?
I am a 43 year old woman (ex-smoker). I was recently diagnosed with low-grade non-invasive bladder cancer. The cancer was discovered because I was having flank/lower back pain to begin with, and then it progressed to pain in all of the pelvic bones. I went to a family doctor who told me I had blood in my urine and referred me to a urologist. When I saw him he completely dismissed the pain that I was having and told me it was not related. However he did find a tumor in the bladder and removed it. The day after the surgery, the pain was completly gone. However, after about 2 weeks the pain began returning. It is not as bad as it was before the tumor was removed but is constant and gradually increasing. I hesitate to see the same urologist for the pain since he was so dismissive about the pain. Is he right? Could the pain be unrelated? Seems unlikely to me, but if so what type of doctor should a see?

Answers:

Without seeing your medical records it is hard to tell and it is also hard to second guess the treating physician since they have all the information.
You need to see another doctor simply because you are not comfortable with this one and with this condition it is important that you have a good relationship with your urologist. And it is a urologist you need to see for this.
Although these cancers are not often fatal follow up is VERY important as about 75% recur. If you continue to catch it before it progresses you are likely to live a normal life.
Did he recommend BCG after your surgery or other imaging exams to evaluate your pain problem?
Take your records, the operative report and the pathology report at a minimum, and take them to another urologist for a second opinion. This doctor should explain the situation to you so that you understand completely and should take your pain seriously.
There is NO reason to see an oncologist or a GYN for this condition and there is nothing they can do to treat you for it.


EDIT: Although I am sure John above me is trying to be helpful there is NO reason to think there is metastatic disease – it is a non-invasive cancer so it cannot be metastatic.
Staging and reporting cancer is my job.

I am a cancer registrar.



No one on yahoo can say whether they are related or not.

You have a lot of potential specialists to choose from. First, you are totally legit to see an oncologist (I am assuming you haven't seen one). They are the experts at staging cancer, and knowing the pattern of metastasis, and it is worth your time to see one, and get the testing you need to exclude the possibility of metastatic disease. If it is the bones in your pelvis, an MRI is absolutely the most sensitive method of detecting metastasis, and that would be very important to know and get treated.

Next, presuming you do NOT have cancer in the bones (which would be a high stage of disease), you need either a pain specialist or a gyn who can figure out the source of your pain.

Backtracking a little : does "hydronephrosis" or 'kidney blockage' sound familiar? If so, it may be back (and narcotics in the postop period can mask pain returning, if the blockage is still there or recurrent). It may be worth seeing a urologist again. You can always go back to the family doc, he or she will have no problem getting you examined, imaged, and lab-tested enough to help you make a better decision as to whom to see.

Good luck to you!




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