Hi Ali,
I agree with you that knowledge is power. I also wish there was less delay with the appointments. If I were you I wouldn't worry about BCG and it's possible side effects, good chance a different treatment would be preferred. There's been some news about BCG being ok for immunnocompromised people, but I think a transplant recipient might be pushing the boundaries.
Can you ask if they are doing any clinical trials using the fluorescent dye when they do the TUR? It's been shown to cut back on recurrence and is in phase III trials, maybe the VA is doing it...
Your partner will be getting a TUR before anything else can be planned. Pathology will give the course of how things will go. So for now it's a waiting game.
Cytology is actually quite a good test for high grade TCC, with very few false positives. I think the references to other cytology tests are actually referring to other urine marker tests out there in use today, there are many, with FISH probably the best of them. If you want to read up on this subject we have a page here:
blcwebcafe.org/urinemarkers.asp
Who knows, maybe the VA is using FISH or Immunocyt these days.
Everyone is given cytology for original diagnoses because it's standard and cheap. After the TUR and follow ups begin, many people request and get the newer (and hopefully improved-although the long term results aren't back) tests, along with cytology.
Your partner is lucky to have you out here doing the 'grunt work' for him!
Best,
Wendy