Dear Doctor:

Question

As per previous notes, Mr. Patient 2183 was found to have an invasive B2 (1) ________ cell carcinoma of the bladder on (2) ________ and TUR bladder tumor. Random biopsies showed no evidence of carcinoma (3) ________. However, since the tumor is invasive, we feel that this 52?year-old male would be best with his bladder removed.

We discussed the alternatives, including radiation therapy alone; radiation therapy plus (4) ________; or radiation therapy, chemotherapy, and radical (5) ________ with urinary (6) ________. After presenting the statistics to the patient, it was decided by the patient to go ahead with a combination of chemotherapy, radiation therapy, and radical cystectomy with diversion. We will contact his oncologist, who will give 2 or 3 courses a month apart of MVAC therapy, followed 2 weeks thereafter by radiation therapy, 2000 (7) ________ over 5 days, to the bladder. Two weeks after completion of radiation therapy, a radical cystectomy will be performed and diversion at the same sitting.

In addition, we discussed the various forms of urinary diversion, including the production of a (8) _________ versus a continent (9) ________ versus the standard (10) ________ loop. The patient, after discussion, decided to go ahead with the standard ileal loop since he desires the minimal complication rates. Continent urostomies and neobladders have complication rates as high as 25% to 50%, requiring repeat surgery, and the patient is not willing to run those risks. We will inform you of his followup.


Sincerely,

Answer 1

1. transition
2. cystoscopy
3. in situ
4. chemotherapy
5. cystectomy
6. diversion.
7. rads
8. neobladder
9. urostomy
10. ileal