Hi,
Was Isoniazid tried?
Lamm says (from webcafe),
"Treatment of BCG Side Effects and Complications
By lowering the dose of BCG to 1/3, 1/10/, 1/30, or 1/100th as needed to avoid increased irritative or systemic symptoms, very few patients have any difficulty with BCG immunotherapy.
If irritative symptoms persist beyond three days, fail to respond to symptomatic treatment, or are severe isoniazid 300mg a day can be given. If patients respond promptly, I generally stop treatment after only one or two weeks. In patients who have true BCG infection requiring antituberculous antibiotics, for example symptomatic prostatitis, epididymitis, or hepatitis, isoniazid plus rifampin 600mg daily should be given for 3-6 months. With serious infections triple antibiotic therapy may be needed, and ethambutol 1200mg daily or a fluoroquinolone may be added. BCG is relatively resistant to cycloserine and pyrazinamide. "
By the way, the 5 studies I used to reference on the subject of low dose BCG came from either Japan or Europe. Maybe doctors just don't like to be 'educated' by their patients.
I think your doctor is wise to treat CIS with much suspicion as even the Europeans agree BCG maintenance is needed to adequately treat CIS, otherwise it's cystectomy. And the doctor doesn't think Steve can stand another dose. He may be right, too. I don't think it's very popular in the UK but US uros are often resorting to the BCG (low dose) + Interferon combination for those who BCG fails.
Here is other important info:
"RC should be performed prior to progression in high risk superficial tumors that fail after TUR and BCG. In patients with clinical and pathological nonmuscle invasive disease,radical cystectomy (RC) provides an excellent disease-free survival. One third of patients with high-risk superficial bladder tumors who underwent RC after BCG failure were understaged and had a shorter survival. Tumor in the prostatic urethra at endoscopic staging was the only factor associated to understaging and shorter survival.14"
blcwebcafe.org/bcg.asp#risk
Wishing you and your husband a wonderful time in Dubai.
WEndy