new diagnosis

Like all of us when first diagnosed you have more questions than answers. You will know much more once you talk to the doctor on Friday. A lot will depend on if there is a re grading or if it will stay the same T1 Gr 3 pathology. I think one thing that is universal with anyone with a new cancer diagnosis is we desperately want absolutes. We want to hear that if I do x that it will take care of the problem. What we hear instead is if you do x it should take care of the problem.
A T1 high grade diagnosis comes with differing paths of therapy depending on the wishes of the patient and the doctor’s opinion. Many will decide to go with tumor removal and one of the treatments that are given directly into the bladder. Using a catheter inserted threw the urethra; they drip in an agent that ideally will cause an immune response in the bladder lining. This is done on a schedule and often yearly maintenance if there is no recurrence. BCG is the most common one that they use but there are other agents. Most of these agents while they can cause side effects such as irritation of the bladder and frequency of urination will not cause the side effects commonly associated with systemic chemotherapy. While in the minority from my knowledge an other might say no I want rid of this and I feel the surest way to do this is Radical Cystectomy.
As for can it comes back after Radical Cystectomy the answer is yes, cancer can be unpredictable. But the survival rate following radical Cystectomy is very high. Can it come back following treatment with BCG or a like agent while trying to preserve the bladder, yes it can bladder cancer has one of the highest rates of recurrence of any cancer. The goal of the BCG treatment is to preserve the native bladder, cut down on or eliminate recurrences and to try to keep any recurrences to a lower grade if they happen. Either course of treatment will mean that your father will frequently be checked for the rest of his life to catch problems as quickly as possible. There are people I know that have chosen either path and are doing well years later.
I hope this helps a bit but know that you are going to a very good place for treatment. Sloane Kettering is well respected in the blc world. Make sure that you keep up the good work as your father advocate and that someone is always with him to take notes at all his meeting with his doctor while this is all new.
Good luck and let us know what you find out Friday.