Probability of recurrence

<deleted by poster>

It all depends on the type of chemo.
BCG is "Immunotherapy", not chemotherapy. It is a TB vaccine used to stimulate an immune response which has been shown to be highly effective in killing cancer cells in the bladder. This is a done by a urologist (although some urologists are also classified as urological oncologists).

Mitomycin is a "chemotherapy" drug but in the case of bladder cancer, it is instilled through a catheter directly into the bladder. This is also done by a urologist.

The direct instillation into the bladder gets the immunotherapy or chemotherapy agents directly in contact with the cancer cells.

What we typically think of as "chemotherapy" is when they are injecting drugs into the circulatory system which then gets the drug into the entire body. This is done by an oncologist. Remember that some urologists are also oncologists but usually the ones at major bladder cancer centers (e.g. Memorial Sloan, MD Anderson).

With breast cancer and many other cancers the chemotherapy has to go throughout the body.
With bladder cancer, if it can be caught and dealt with prior to getting outside of the bladder then systemic chemotherapy isn't needed. NCCN has recently updated their guidelines though to recommend some chemotherapy prior to removal of the bladder for T2 (muscle invasive) and above because of a reduction in recurrence.

Does that answer your question?

Mike

I can only reply to the BCG, although I am fairly certain that Chemo would be given by an Oncologist.
A Uro can give the BCG washes, but I would only go a Uro who does this all the time. Most Uro's treat prostrate cancer more often that bladder cancer.
If you have a good bladder cancer doctor near you that would be the best.
Nancy

I would like to know if generally treatments such as chemo or BCG are done by the urologist or an oncologist. Can anyone tell me which is usually the case?

My wife had breast cancer and she went to several specialists including the surgeon and oncologist among others.

My impression is that bladder cancer is different. Or perhaps for early stage you see only the urologist but if the case gets more difficult you see others? Can someone set me straight?

thanks

My CIS was not picked up with the FISH test. My Uro did a biopsy and that is when it was dx'd. However, I still get FISH tests every time I have a cysto, and of course a cytology test.
CIS can be very sneaky. After it was dx'd and I began BCG treatments, I had many, many biopsies. They all came back clear, because my bladder was just beat up from the BCG, but CIS can just look like irritation.
It is always better to be safe than sorry.
Nancy