Bladder cancer advocacy network
June 5, 2011
Hard choices

By ludovic
June 5, 2011 at 6:04 pm
In Newly diagnosed
Shared with the public

I'm 86 years old and in general good health. I had a TURP on April 23, tumor removed
from a thin-walled diverticulum on the right side of bladder. Biopsy at the time revealed I
also have adinocarcinoma. I am preparing to undergo segemental cystocopy to remove
the diverticulum and adjacent bladder wall where tumors are located.
I chose this procedure over a radical cystoscopy because quality of life is important. If
successful, I will still be able to pee normally, (albeit more frequently).
The question posed by my surgeon: "If I find it not possible to complete the partial, do
you prefer I continue on to do a radical or do I close you up?"
Hypotetically, knowing what you now know and you were 86, what would you answer?
BTW, were I to elect for a radical, which urinary diversion would you recommend?

...By ludovic
Reply 2305144
July 3, 2011 at 4:56 pm
Report post

Thank you to all who offered opinions and advice based on your own experiences.
They were, of course, of tremendous value in electing the course for me to follow.
Firstly, I have to express my thanks to and admiration of the skills in both diagnosis and
surgery of Dr. HUATHIN KHAW , the specialist who has taken care of my uroligical
needs for about 17 years at Kaiser Permanente in San Diego.
Secondly, I have to attest to his humility and empathy by reporting that he readily
organized an appointment with another urological specialist for a second opinion before
deciding on the final course of action.
Thirdly, based on his finding that the adino tumors appeared to be located only in and
close to the diverticulum and his assessment of the area available to him to excise them
and still leave adequate tissue for stitching and reclosing the bladder, we agreed to go
with a diverticulectomy and partial cystectomy.
The surgery, held on June 18, lasted for 5 hours and resulted in his removing the
diverticulum plus a happily-small 10% of my bladder. Subsequent path results showed
tumors gone and margins clear of cancer, as were the nearby lymph nodes.
For the time being, I am cancer-free and suffering a diminishing amount of discomfort
following removal of a drain tube and catheter, and the slow healing (I'll be 87 later this
month) of the incisions.

I've noted, with increasing thankfulness for my own good fortune, the anguisihing
choices some sufferers have had to make in respect of the cost of the treatment they
require. As a member of the Kaiser Permamente Senior Advantage program, the only
contrbution I have been asked to make is a $200 per night hospital charge. My surgery
and the subsequent state-of-the-art nusing help, plus all needed supplies and follow-up
visits for device removal, etc. have been at no charge. For those who may not qualify
for such a program, I can only say that I am totally amazed that any right-thinking US
citizen, except thos who own shares in healthcare insurance companies, would vote
against a political party that advocates free healthcare for all paid for from general
University of Washington Clinical Trials

Clinical Trials are carefully controlled
studies that are conducted in humans who
volunteer to test the effectiveness and safety
of new drugs, medical products or

Cranberry: Interactions with Anti-infectious

PI: Gail Anderson, PhD
Co-investigator: Richard W. Grady, MD
Agency: NCCAM / NIH
Type: R21
Period: 1/15/04 – 1/05/07

Evaluation of orally ingested cranberry and
antibiotic interactions in the urinary tract.

Evaluation of Continence in a Spina Bifida

PI: Kathryn Smith, MSN, PhD
Co-investigator: Richard W. Grady, MD
Agency: Centers for Disease Control
Period: Aug 2005 – July 2008
Prostate Cancer Clinical Trials

Hormones, Nutrients, and Gene Expression in
Prostate Tissue

PI: Daniel Lin, MD
Sponsor: Intramural
Period: 2003-present
38th Global Congress of Minimally
Invasive Gynecology
.pdf - Block all results
laparoscopic urologic procedures and
laparoscopic gynecologic procedures.
Contraindications The GYNECARE
MORCELLEX™ ..... So You Want to
Participate in Clinical Research Trials?
...... Smiley Technique. Expert
Technique. Cinch Technique ...
Thank Heaven for
Insurance Companies blog
San Diego
Education Report
Cardiology score card
Retaliation by Kaiser
Missing Medical Records
Warnings deleted from abnormal
test results
Conflicts of interest
Failure to diagnose
Cases and news
missing x-rays
Peer review
Paul Bernstein and Kaiser writers
Remediating failure to diagnose
Mary Ann Barnes
Kaiser executives
George Halvorson, Kaiser CEO
Profits grow as Kaiser cuts care
Blog: Kaiser Permanente
Dr. Eugene Rhee, chief of urology
Lynette Seid, CFO San Diego
X-rays (VUCG)
James G. Malone
Dave Horton
Comparison San Diego  hospitals
Kaiser Permanente links
Kaiser department rankings
Cancer score card
Diagnostic Imaging
Medical Records
US Health Insurance companies
consent form
Healthcare reform
KP On Call
Lawyers and doctors
Yvonne Hanzen
Nathaniel L. Oubré, Jr.
Dr. Huathin Khaw, San Diego Kaiser Permanente urologist
Tampering with X-ray results?
Dr. Khaw signed a report, then large parts of the report disappeared