Three Month Cystoscopy

Thanks Jack. Would you agree with Sara Anne's opinion that I should have had maintenance BCG after the initial 6 BCG treatments, and a successful biopsy? Would you also concur that with a clean biopsy that included 6 biopsied areas that I should be positive about this follow up cystoscopy.

Mistersac,

How to treat BC is a hard question; when can treatment stop? In the end, each of us has to make the decision of what treatment we will accept, being a particular doctor's recommendation or one of the community "standards".

Following a widely accepted treatment plan, there are few surprises. When a plan lacking in future details is offered, the present and future possibilities are less clear.

Below are links to three consensus documents on the treatment of NMIBC, including BCG usage. There are slight differences between the recommendations.

BCG decisions include; when to start BCG, how long to continue BCG, how to proceed if initial BCG fails, what is BCG failure, when is maintenance BCG recommended, and options after BCG fails and/or there is a grade increase in the cancer.

Canadian Urological Association, 2016
www.ncbi.nlm.nih.gov/pmc/articles/PMC4771569/

NATURE REVIEWS UROLOGY | CONSENSUS STATEMENT 2015
www.nature.com/nrurol/journal/v12/n4/full/nrurol.2015.58.html

Consensus NMIBC American Urological Assn 2015


The first and third (long) articles consider the strength of evidence and recommendations. The second article is very heavily and directly influenced by the work of Dr. Donald Lamm - Lamm speaks directly to maintenance BCG treatments.. All of the articles consider and include Dr. Lamm's work.

I found these documents helpful in reaching my decision. I hope they will assist you.

Best,
Jack

Sara Anne I fully appreciate your advice, and this forum has been a great source of guidance through this journey. I know that my URO does and has treated many cases of bladder cancer. Where can I find research that speaks to the value of BCG maintenance. I find it hard to fathom that when I asked directly about BCG maintenance, and said I was willing to go in that direction if he thought it was warranted, that he wouldn't have ordered it if he thought it necessary. Thanks again for your continued advice, and the good work you do on this forum.

Is maintenance considered standard in the community, or is his determination based on the 6 biopsies, and what he saw during the procedure a calculated call? In your mind does this change your opinion that this cystoscopy should be faborable?