[confused]

My father was diagnosed with bladder cancer couple weeks ago. The urologist said the tumor has not invade the bladder wall or muscle. It is at Ta. However, the biopsy report said the cell grading is High grade. The urologist said this is a new grading system and it correlates to a Grade 1 and 2 in the previous grading system. The course of treatment is to monitor closely to make sure the cancer does not come back. My dad is to have bleed test followed by x-ray of the kidney and then another cytoscope exam in a month. However, when the biopsy report was read by my dad's general physician, he recommended my dad to see a cancer specialist because it is "high grade".

I researched the grading system and found the information contradictive - how can it be high grade correlates to grade 1 and 2? Bottomline, what does it mean? Should we go see a cancer specialist?

[UroDoc]

Bottom line, if it has not invaded then it is superficial disease which needs cysto every 3 months for 2 years, followed by every 6 months for 2 years, then yearly assuming no new lesions are found. If new lesions are found then immunotherapy placed in the bladder via a catheter would be the recommended therapy. The grade you are talking about means the higher the grade the more likely the cancer will come back. Given the high grade you could make the argument to start immunotherapy early (prior to a recurrence of a lesion), and that is a discussion you can have with your urologist. However the plan he/she is recommending is appropriate. At this point a cancer specialist (oncologist) will have nothing to add. Good luck

[confused]

Thank you for your reply. I will make sure my dad is 100% compliance to having the cystoscope exam regularly.