Gabriel,
Sorry to say this but it is time your father gets off the Canary Islands and gets to a bladder cancer specialist somewhere.
I went back and looked at your previous posts and I am pretty surprised by the treatment plan so far.
Multiple T1G3 tumors and then to have multiple recurrences is a very strong indicator that the doctor should be talking about a radical cystectomy (RC). The first recurrence, no matter how small, should have been another TURBT given that we are talking about high grade. Ta or not Ta isn't the point. You could almost assume that any recurrence would likely be high grade but the TURBT could have at least confirmed that. And with that confirmation (or even that assumption) the doctor at that point should probably at least have initiated another round of BCG.
Now, it is back yet again. Even one recurrence of high grade bladder cancer should trigger the discussion about RC. Multiple recurrences of high grade should trigger the doctor to be STRONGLY recommending an RC.
This isn't MY opinion, it is opinion of bladder cancer specialists. Here is a link to where I posted the NCCN Guidelines for the treatment of bladder cancer.
bladdercancersupport.org/su/forum/3-newly-diagnosed-/33885-nccn-clinical-practice-guidelines-in-oncology-blc#33886
These guidelines are established based on the best outcomes, supported by empirical data and agreement of a group of bladder cancer specialists.
Here is where I tried to make a somewhat more simplified version (before I knew about those guidelines):
bladdercancersupport.org/images/Bladder%20Cancer%20Treatment%20Guide%20v4.pdf
While his doctor likely won't care about my flowchart, the NCCN guidelines should carry some weight. I'd suggest printing out the relevant pages (T1G3 with multiple recurrences), taking that to his doctor and saying "What the heck?!?!".
Then I would suggest finding a top bladder cancer specialist doctor in mainland Spain (if Spain is his only option) or elsewhere if that is a possibility.
I am not saying his current doctor isn't a nice guy and all but bladder cancer is not to be messed with and the guidelines exist for a reason and the best outcomes happen to patients who get to the best doctors (specialists in bladder cancer). For an RC, he should have the best surgeon and it should be someone who does 50 or more of the surgeries a year.
Even if he was not in the Canary Islands, I would be suggesting you consider the same thing. Please review the information from the links I posted and then go over all of that with your dad. He needs to be able to make a truly informed decision on this. He's way too young to do otherwise and this is really important.
I'm not a doctor and the advice above isn't medical advice. The advice above is meant to encourage you to get him somewhere that bladder cancer is a specialty so that THEY can give the medical advise.
Mike
PS: I am doing great. Thanks for asking.