SWArmy,
Your comment of being treated like a mushroom got to me. I have heard it too many times, and have fired doctors because of it. At the same time, I have a fine care team (local limited doc, regional health center urologist, and a university oncology group - plus staff) that provides what they can - which is a fairly standard set of treatment plans.
Reading vetted, respected medical articles gave me the tools to discuss possible courses of action with my doctors. Some like informed patients, some hate them. I have been reading non-stop going on 5 years.
Each of us has a unique medical history that needs to be considered. I don't believe that one-size-fits-all. We need the Docs to put the pieces together, AND we patients need to have a better (or GOOD) idea of the range of treatments available. To that end may I suggest the following LONG article about BCG by one of the experts in the research and treatment field.
'Expert consensus document: Consensus statement on best practice management regarding the use of intravesical immunotherapy with BCG for bladder cancer'
From, Nature Reviews Urology volume12, pages 225–235(2015)
Dr. Donald Lamm, covers the range of BCG topics, from when to use, what to expect, and other options after BCG fails.
www.nature.com/nrurol/journal/v12/n4/full/nrurol.2015.58.html
While there are thousands of articles on BC and BCG, this one offers a decent look at the range of concerns about basic treatment decisions. Things that a treating Doc should be able to discuss with her/his patients.
It is great that BCG has produced so many good results for lots of people here. For some of us, BCG did not do it.
I have only one kidney, following a major injury, and the kidney developed cancer after the bladder cancer. I have great incentive to keep the kidney, less concerned about the bladder, but most Docs want to take both at the same time, which would result in a life on dialysis, which I would like to avoid. Thus I have a great interest in those reasonable treatments that that have a track record after BCG failure.
For me, IF the bladder cancer goes invasive, then the other treatments are off. It is then time to remove the bladder to prevent metastatic spread. Doctors differ on when to go to "the gold standard" - the RC.
I hope this sort of info helps.
Best
Jack