RNR: Papillary urothelial carcinoma, High Grade, T1, invasion of subepithelial connective tissue

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 Papillary urothelial carcinoma.

  • No lymph vascular invasion 
  •  muscularized propria- uninvolved in carcinoma

Rating System: Lowest to Highest

 0 (T zero): There is no evidence of a primary tumor in the bladder.

Ta: This refers to noninvasive papillary carcinoma. This type of growth often is found on a small section of tissue that easily can be removed with TURBT.

Tis: This stage is carcinoma in situ (CIS) or a "flat tumor." This means that the cancer is only found on or near the surface of the bladder. The doctor may also call it non-muscle-invasive bladder cancer, superficial bladder cancer, or noninvasive flat carcinoma. This type of bladder cancer often comes back after treatment, usually as another noninvasive cancer in the bladder.

T1: The tumor has spread to the connective tissue (called the lamina propria) that separates the lining of the bladder from the muscles beneath, but it does not involve the bladder wall muscle.



T2: The tumor has spread to the muscle of the bladder wall.

T3: The tumor has grown into the perivesical tissue (the fatty tissue that surrounds the bladder)

T4: The tumor has spread to any of the following: the abdominal wall, the pelvic wall, the prostate or seminal vesicle (the tubes that carry semen), or the uterus or vagina.


Treatment proscribed:

intravesical Therapy

BCG: 

Types of intravesical therapy

There are 2 main types of intravesical therapy:

  • Immunotherapy
  • Chemotherapy

BCG is the most common intravesical immunotherapy for treating early-stage bladder cancer.

BCG is a germ that's related to the one that causes tuberculosis (TB), but it doesn’t usually cause serious disease. When BCG is put into the bladder as a liquid through a catheter, it helps "turn on" the immune system cells there, which then attack the bladder cancer cells.

Side effects of BCG: Treatment with BCG can cause a wide range of symptoms. It's common to have flu-like symptoms, such as fever, aches, chills, and fatigue, which can last for 2 to 3 days after treatment. It also commonly causes a burning feeling in the bladder, the need to urinate often, and even blood in the urine.

While getting BCG doesn’t usually make people very sick, serious BCG infections are more likely in people who have a weakened immune system, so this treatment typically isn’t recommended for these people.

If a serious infection does happen, one sign of this can be a high fever that doesn't go away. If this happens, call your doctor right away

 

BCG Immunotherapy


Bacillus Calmette-Guerin (BCG) is an immunotherapy derived from bacteria used to treat some kinds of bladder cancer.1 The body’s natural response to BCG is thought to help the immune system better respond to cancer cells. It is given as an intravesical therapy, inserted through a catheter to reach the interior of the bladder. TICE BCG is the brand name of the BCG intravesical therapy that is currently on the market.


  • BCG is recommended following tumor removal for some people with non-muscle invasive bladder cancer (NMIBC). 
  • In this kind of bladder cancer, the muscular bladder wall has not yet been affected. 
  • BCG is recommended for people with high-grade tumors (which look more abnormal under a microscope). 
  • It is recommended for some lower-grade types of NMIBC tumor as well.1
  •  It is still the first-line treatment for these types of cancers. BCG therapy has not been approved for treatment in children.

https://www.medicalnewstoday.com/articles/319477

Keeping your Immune system Healthy during BSC

https://www.webmd.com/cancer/cancer-treatment-protect-immune-system

Search Results

https://bladdercancer.net/living/expect-bcg-treatment


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Nutrition to prepare for immunotherapy

https://www.healthline.com/health/bladder-cancer/bladder-cancer-diet-and-nutrition

vegetables, fruits, legumes, and whole grains. It also includes healthy fats from fish, nuts, seeds, and olive oil.

chicken, fish, eggs, beans, lentils, soy products, nuts, seeds, and dairy. Try to include a source of protein with all meals and snacks.

Healthy sources of fat include fish, avocados, nuts, seeds, olives, and olive oils.

green tea because it’s rich in polyphenols. Polyphenols are compounds that occur in some plants and may offer health benefits.

Research has also associated Western-type diets with an increased risk of bladder cancer recurrence. The Western dietary pattern is rich in highly processed foods and low in fruits and vegetables.

https://www.hopkinsmedicine.org/health/conditions-and-diseases/cancer/cancer-diet-foods-to-add-and-avoid-during-cancer-treatment

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