Dave,
Sorry to hear of the new development.
The thinking about my chemo & concurrent BCG was a bit different. Not sure if it truly relates, but will offer a question or two to ask the docs.
A year ago, it was BCG maintenance time when cancer was found, at CT, in my kidney (I only have one - the other was lost in an accident). I was told that chemo with only one (cancerous)) kidney would be rough, if at all possible. I elected to go the chemo route - Five 3 week cycles of Cisplatin and Gemzar - AND the three week BCG maintenance at the same time.
Chemo involved a long list of "other" drugs, all intended to combat chemo side effects - constipation, diarrhea, mouth sores, nausea, etc. Additionally there were pre and post chemo IVs to prepare and flush the kidney.
The oncologist disagreed with the urologist's recommendation to eliminate all steroids. They were explained to be used as part of the drug program to prevent nausea. Steroids were both daily tablets and at each IV. The urologist felt that the immune suppression from the steroids was counter productive to BCG treatments; the oncologist disagreed and suggested not combining BCG with chemo. I chose to do both without the steroids.
It was really a choice between the opinion of the urologist I know and like, and a new, first time oncologist I did not know.
The BCG experience was no different than all the prior BCG treatments.
The kidney cancer no longer shows on scans. Chemo doses had to be reduced a couple of times, and week long breaks were added to get me through. It was worth it all to keep the kidney and avoid the dialysis that would be required if I lost the kidney. The bladder T0 CIS seemed to be gone, but promptly returned. I did not feel that I lost anything by not taking steroids. Maybe it increased the nausea and vomiting, hard to tell.
All that to say, see what your urologist thinks of having BCG and steroids at the same time. Then ask the oncologist what the steroids (prednisolone) adds to the R-CHOP if it is an issue. My immune system took a major hit during chemo, like most people, it is a standard side effect - weekly blood draws watch for it. The best decision I made was to have a port installed to save my veins. Utter fatigue was the worst side effect. Things continue to move in the right direction.
Best to you on the new journey. Hang in there,
Jack