Others have given you good advice, so much of what I say will be repeats, but that is not always bad
First, since you have been dealing with other cancers, your are fortunate to be being seen at a place like Hopkins. I feel confident that the expertise is there to cover any problem you might have.
You will be having a TURB, as mentioned above, which does two things. First, it will remove the nodule (tumor?) and second, will provide samples for the pathologist to examine to determine IF it is indeed cancer, and, if so, what the situation is.
They will NOT instill BCG after the TURB. If they do instill something, it will most likely be mitomycin...which IS a chemo agent when administered systemically, but in this case is to prevent any seeding, as has been mentioned. BCG is NEVER administered if the bladder is so much as irritated, since that would provide an avenue into the bloodstream, which you do not want.
Yes, there can be some severe side effects to BCG, but they are rare. Many of us here have been through the series with no more than minor effects. It is possible, even if you have a diagnosis of bladder cancer, that this may not be recommended. It will depend on what the pathology report indicates.
If you still feel that you need a second opinion, there is a list of places with excellent bladder cancer treatment available from the Treatment Center Finder on our home page. Once good place would be Memorial Sloan Kettering in NYC or Mass General in Boston.
There are various tests that can be done on urine samples to see if there are bladder cancer cells present; these are now valuable only as supplements to other diagnostic tests and have issues with both false positives and false negatives. There do not appear to be any genetic tests commonly used such as are done with breast cancer. The "gold standard" of diagnosis is still the TURB and the pathology that accompanies it.
Back to one last question you had on BCG treatments. They are no "big deal" and can be done just about anywhere. I would much prefer to be close to home (and my own bathroom!) In my case, it was administered by a BCG-nurse in my urologist's office and I then headed home. The first four hours or so are a bit uncomfortable, but very do-able. But you are not there yet!!
Any more questions?
Sara Anne
