A male 9 years old with erms urinary bladder received all cycles of chemotherapy then underwent partial cystectomy with all margins positive for fully cytodifferentiated cells, taking in consideration that all the respected tumor was fully differentiated, ki67 is 0% and no expression of myogenin by ihc. Does this patient need total cystectomy or can be watched under follow up.

Dr. Kunubilli Vara LakshmiHomeopathy Doctor3yrs exp

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Dear Lybrate user! ki67 marker of metastasis is 0 percent means very low chance to spread further. Here "no need complete cystectomy at this moment. But, patient must be under regular monitoring. According to nobel prize winning article regarding cancers: cancer cells can multiply under rich co2 and glucose. We can reduce multiplication by filling more oxygen into our cells by doing exercises and by minimizing glucose content in the cells. Thank you.  

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