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HIV & Bladder Cancer
Oct 25, 2010

I was tested positive in 2009 and just a week ago, my doctor confrmed that I have adenocarcinoma of the bladder. He usggested surgery but I am not in favour of doing that as I value quality of life. I have not told this doctor about my HIV condition. If I do not go for surgety, what other options are there are me

Response from Dr. Frascino

Hello,

I am not an oncologist or urologist and therefore not qualified to suggest treatment options for adenocarcinoma of the bladder.

I find it very unfortunate that you chose not to disclose your HIV status to your doctor! Adenocarcinoma can be a very serious condition and any type of treatment (surgical or non-surgical) will need to be coordinated with your HIV care and therapy. I would strongly recommend you discuss your recent bladder cancer diagnosis with your HIV physician. If you don't feel you can be honest with the oncologist or urologist who diagnosed your cancer, you should ask your HIV specialist for a referral to another oncologist/urologist with whom you hopefully could work closely and honestly no matter what you choose to do or not do to treat your adenocarcinoma.

I absolutely understand your desire for "quality of life." It needs to be factored into any treatment equation. Surgery is never something to be taken lightly and I always suggest a second opinion before any elective surgical procedure. I have published several articles that focus on quality of life issues in HIVers and strongly believe each of us should be intimately involved in our treatment decisions. However, it's important to look at all aspects of quality of life. True, if you underwent surgery for any condition, there would be a period of time necessary to heal up after the procedure. But if by surgically excising a malignant tumor you could essentially be cured of cancer, and the alternative is a protracted painful illness and undignified death, this might well swing the "quality of life" issue in favor of surgical intervention. As some of my surgeon friends remind me, it is possible to "heal with steel," depending on the specific condition being treated.

I do hope you'll get additional information regarding your treatment options and the potential consequences of each of your options. I also encourage you and all forum readers to disclose your HIV status to your healthcare providers. If you feel you can't, you need to find a new health care team!

Good luck, whatever you decide,

Dr. Bob



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