O.k. saw the oncologist at Sloan Kettering yesterday, wanted to report information that others may find useful.
First, I asked whether it is possible by looking for genetic markers on tumor cells, to determine whether BCG treatment is more or less likely to be effective. Answer: not at the moment. Research underway but at present, can't distinguish those cancers which will be more susceptible to BCG from those which are less susceptible.
Second, I asked whether cancer type can be distinguished through pathology with more specificity than just "low grade" or "high grade." Answer: not usefully for treatment purposes. Yes they can see differences on a cellular level but nothing that is clinically useful at the moment.
Third, I asked what the overall likelihood of recurrence was and what parameters went into calculating that. Answer: size of tumor upon first detection was important; general probability for recurrence is around 34% for first five years but they took the size of my tumor (17mm X 14mm X 11mm), plugged it into an equation they had and calculated 46% in my case. Oh well!
Finally, I asked them about whether the discomfort I was continuing to feel in the bladder could be an early recurrence, they reassured me that was certainly not the case, just the bladder healing from the TURBT (which at this point was 19 days ago). I have a follow-up cystoscopy tomorrow and then a followup TURBT probably next week to ensure that the tumor was fully removed the first time.
One other note. I told the doctors at Sloan Kettering that owing to a very bad childhood memory of cystoscopy, I really needed to be knocked out for any transurethral procedure, but did not mean to sound like a wimp - this was just my biggest phobia in life. They assured me that there are many patients in my category and it is not uncommon to use propofol for such procedures although of course they prefer not to since anesthesia brings with it its own potential for complications.
So that's what I learned. I'll probably start the BCG in a few weeks, unless the repeat TURBT finds further evidence of cancer in which case cystectomy becomes more likely. Only time will tell.