(1) When I had a first recurrence, almost two years ago, my uro did not do the immediate instillation of mitomycin that is now recommended; I'm not sure whether this was as much of a "standard" and recommended protocol then, but if I ever have another recurrence and TURBT, I'd sure ask him about it and push for it. If I were you, I'd definitely ask about getting the mitomycin at the time of the TURBT. I can't recall the exact time line, but believe it's recommended to have the single dose of mitomycin at the time of or within hours of the surgery; the idea is to prevent/forestall any possible "seeding" of cells from the area where the tumor is removed.
(2) My uro recommended I start the BCG treatments when I had the recurrence, even though the tumor the first time and the 2 very tiny ones the second time were low grade. I had read that BCG is less effective on low-grade tumors, but apparently the recurrence itself, irrespective of grade, can lead to a recommendation for BCG. My cousin, a radiologist specializing in the urinary tract concurred with my uro, and he said that the recurrence was an indication that "your bladder lining wants to grow tumors." (The new tumors were not in the same area as the old one, and were also not right next to each other.)
I had the 6 weeks induction, and have been getting maintenance BCG treatments since, first every 3 months and now every 6.
Just had a 3-month checkup, and I'm still all clear.
Ann
