I had a very large bladder tumor (required 2 TURBs to remove), and am half way through my first cycle of BCG (not as bad as I thought it would be). My pathology report noted that though 95% was low grade, I had focal high grade features as well which can indicate higher chance for recurrence. I'm also 37, there might have been the instinct to do anything so I can keep my bladder. It's a conversation between you and your doctor because there are so many factors that go into recommending a treatment. Good luck.
First cysto and TURBT 5/23/2016
Nephrostomy placement 5/24/2016
Second cysto and TURBT 6/20/2016
Papillary urothelial carcinoma, mostly low grade
No stromal invasion, no metastasis
Original tumor size (by CT): 7.3 cm x 4.8 cm x 4.8 cm
Starting BCG 8/21/2016
Dx 5/25/2016, First cysto and TURBT 5/23/2016, 2nd cysto and TURBT 6/20/2016, Original tumor size (by CT): 7.3 cm x 4.8 cm x 4.8 cm, BCG 8/31/2016-10/12/2016,
Cysto 11/15/2016: Recurrence , TURBT (#3) 12/5/2016, BCG x 3 weeks, off 1 week x 1 year (end Jan 2018)
Cysto 4/5/17: NED!!
The following provides an opinion about treatment based on a "risk of recurrence" as well as invasive v non-invasive.
Bladder cancer treatment; non-muscle invasive (superficial) cancer Michael O'Donnell MD
O'Donnell describes three levels of " risk of recurrence" in the section titled " ADJUVANT BLADDER CANCER THERAPY".
This may may provide you some insight, about which you can ask your doctor.
Note: The author is well known; the website is an unknown to me.
What's with this Bleeding ? 6/2015
DX: HG Papillary & CIS
3 Years and 30 BCG/BCG+Inf
Tis CIS comes back.
BC clear as of 5/17 !
RCC found in my one & only kidney 10/17
Begin Chemo; Cisplatin and Gemzar
8/18 begin Chemo# 3
Begin year 4 with cis
2/19 Chemo #4
9/19 NED again
1/2020 CIS is back...
Sometimes it will be prescribed based upon increasing frequency of occurrence. Could also be because of tumor size. These two observations are just what I remember from other threads. None of us are doctors, so there may even be other reasons but, you are correct, I understand that low grade usually doesn't respond well. As most of us will say, if in doubt get a second opinion.
DX 5/6/2008 TAG3 papillary tumor .5 CM in size. 2 TURBS followed by 6 instillations of BCG weekly with a second round of 6 after a 6 week wait.
3 years 8 months ago - 3 years 8 months ago#52010by Win55
I have been told that low grade bladder cancer does not respond well to BCG treatments and is not necessary even if it is recurrent. I know a lot of patients with low grade cancer receive BCG though and I have as well. Anyone know why some doctors treat low grade cancer with BCG and some don't? I have searched the internet and can't find much info on the subject.