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I understand your concern but nothing in life is without risk. To me BCG would be the decision with close watch.
Let me add another option: in Europe and Japan more and more institutions use bladder preserving therapies (i.e. radiation and chemotherapy) for muscle invasive tumors with same or better survival rates as RC. In the US, however, you can only get this in a clicinal trial.
Check out this:
http://www.ncbi.nlm.nih.gov/pubmed/20811698
T1G2
TUR 05/10/2010Jim,
Since you tolerated BCG before, there is no reason to expect it to be any more lethal that it was the last time. BCG is often effective. It can be lethal if you get sepsis but that is why your uro should not administer it if you have blood in your urine. Since you are now high grade, the standard treatment is the 6 initial doses followed by maintenance doses. Research has shown that the maintenance doses are VERY important. This is sometimes considered unneeded in low grade cases but I think the jury is still out on that one.
Whenever you get surgery for anything that is going to put you under anesthesia you have to sign some paper about the risks and that also pretty much always says it can be lethal.
You have to balance the risk with the reward. If BCG works for you and it keeps this at bay and you keep your bladder, that’s a good thing.
If it doesn’t work, and you get a high grade recurrence or any progression, then that seems to be the time recommended for RC.
I had my RC 2 years ago because I failed BCG (bad reaction) two years prior to that and mine came back and became invasive.
An RC is pretty always a valid option but surgery carries risks as well.
Ask your uro about the antibiotics that are used when a reaction to BCG happens. If you go that route, it may be worthwhile to have him give you a prescription for them so you have them on hand if there is a problem.
Many, many people get BCG. There are side effects from the medication but that is what shows that it is working. The lethal part is if it gets into your blood stream which should not happen if there is no blood in urine at the time of administration. Did your uro say why he thinks it would be higher risk this time versus last time you got BCG?
Also, consider discussing the dose strength with him. Dr. Lamm indicates that even low doses have shown just as good efficacy and there is a lower risk of severe side effects.
Mike
Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results….distant mets
2/2014 ct result…spread to liver, kidneys, and lymph system
My opinions are my own and do not reflect the opinion of ABLCS or anyone else. I am not a doctor nor do I play one on TV.Jim,
I see you are a Boilermaker! I am too. 1974.
Glad you found the site and sorry your BC has graded higher. Your Doc gave good advice. As long as it’s not muscle invasive BCG is a great option but, other here have also said to heck with it and done the RC. Both are valid. There are people that monitor this site that will chime in with more help such as how good the docs are at IU. I know Pat has indicated some are very good.
While BC is nothing to fool around with I was DX 2 1/2 years ago high grade (G3) but opted for BCG and am still clear to this day. Lots of variables here as everyone is different. My BC was caught very early- just had hit the first layer.
Keep checking back for more opinions and more info. This is an incredible sitet for info. Browse around on older subjects and forums.
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.Sign In to reply.