Peg…Surprisingly, low-grade urothelial carcinoma is relatively more responsive to chemotherapy(Mitomycin C) than high-grade carcinoma. In contrast, with BCG immunotherapy, low-grade tumors appear to be relatively less responsive. Therefore, chemotherapy is used initially in low-grade disease, where the risk of progression is very low and the side effects and cost of a single postoperative treatment are also appropriately low. And more doctors are now going with a 6 week regimen of mitomycin C.
So my guess is that O’Donnell did the right thing based on a low grade urothelial carcinoma…….but now that there is progression not necessarily in grade but more tumors….he’s going to give the BCG a shot and take a look in there at 6 weeks. I doubt that he would commit to long time treatment at this point as his priority is not letting this demon get out of control.
Pat