This is the recommendation from my doctor...
There is another therapy we should consider. This is called immunotherapy (immune system related therapy). This is done by placing a small catheter into the bladder and putting in a small amount of liquid containing the vaccine for tuberculosis. This is done once a week for 6 weeks starting 3 weeks after the surgery. It is then repeated once a week for 3 weeks at 3 months, 6 months, 12 months, and 18 months after surgery for a total of 27 treatments.
Here is a guideline analysis of this treatment:
However, in this high-risk group, maintenance BCG is superior to mitomycin C with or without maintenance. In our single-arm meta-analysis of randomized controlled trials of high-risk patients, the estimated five-year recurrence rate was 34% in patients receiving TURBT and BCG maintenance and 62% with mitomycin C maintenance. The meta-analysis of all risk groups found that, compared with TURBT and mitomycin C maintenance, TURBT and BCG maintenance therapy reduced recurrence by 17% (95% CI: 7, 26). In addition, there are limited data suggesting a trend to preventing progression with maintenance BCG. The progression in one study of 380 patients was reduced by 5% (95% CI: -1, 11) with TURBT plus BCG maintenance when compared with TURBT plus mitomycin C maintenance.84 Although maintenance therapy reduces recurrence and may reduce progression, the side effects and discomfort of the treatment and possibly the costs of the treatment may outweigh the benefits for some patients. Thus, discussion of the tradeoffs and consideration of patient preferences is important before beginning or continuing maintenance therapy.