Hi, and welcome,
I read an article recently about guidelines and bladder cancer, and the trouble is that nobody follows them, less than 5% of uros who were surveyed. What better way for uros to get educated than for patients to point out recommended guidelines and ask for them to be used?
As to your question about the choice between uro or oncologist, in an ideal situation the answer is a uro-oncologist. There can be many modes of treatment coming into play depending on things. A good pathologist is also a must, and uro-pathologists are only found in the top institutions. Second opinions on pathology are often recommended if there's the slightest doubt of putting yourself at risk of mis-diagnosis.
Understaging is common, as is overstaging, but of course the risk lies in missing a muscle invasive tumor and treating it too conservatively. The 2nd TUR approach can be very informative, tumor is found on the re-TUR too often with T1 tumors. Now it's official in both the US and Europe to do a 2nd TUR for T1 or high risk tumors.
Your doctor is following the guidelines when it comes to recommending BCG for a T1 high grade tumor, it is an excellent treatment if it works (and it does most of the time).
I wish you the best,
Wendy