Recurrence - Timing

Hi Franck . There does not seem to be a standard pattern as regards recurrences. Some people have frequent recurrences, others can go years and some never have it come back. The positive is we are checked regularly and anything can be dealt with early. Two months waiting seems to be usual. In some cases if they think BCG has been unsuccessful, they may change it to something like mitomycin. This is a chemo treatment rather than immunotherapy, but administered in the same way. As regards anything else going on, it is usual to have a CT scan early on just to check. Something you may like to ask your team about. Best wishes.

Hi Franck, as rily says, no standard pattern. My OH had a recurrence found immediately at 6-weeks-after-6-BCG check. [As it was handily under GA due to strictures, they TURBT'd it there and then] They then said he had "3 equal options, more BCG, bladder removal or Mitomycin into bladder". He was horrified at prospect of bladder removal.

Then we hadn't joined this forum, where I have come to learn that recurrences do not necessarily mean that BCG has not worked, just that you need some more of it. hence the consultant offering this to him. So he went for 'try Mitomycin' For him this has been very successful, around 5 years clear now though a couple of 'red patch scares'. Many people have those. It is peace of mind how you are monitored as regularly as they consider necessary.

His original stage/ grade was pTa G3 but it did cover his whole bladder and had been there a long time. Hope this helps, 

Denby

Bear in mind that we are not medical experts & can only speak from experience. The  new growths could well be a recurrence, which indicates that the BCG is not being effective, but you will not know if it has progressed or not until a biopsy has been done. If the growths are a recurrence at lower grade, then more BCG (or mitomycin) might be considered a reasonable option. If higher grade again, more aggressive action may well be recommended. They may schedule other tests eg CT scan, to ensure they have all the information they need to know as well as they can, what is going on. Your consultant should discuss with you what options are recommended by the Multi-Disciplinary team, the pros & cons & risks & benefits of each. Then you can make an informed choice. 

Hi Franck.  I had a recurrence after my induction 6 BCG (I had a course of 6 BCG following an earlier recurrence after a year of mitomycin).  They removed the recurrence with laser (took 10 minutes, no side effects at all) rather than TURBT this time as my previous recurrence had been low grade and they were confident the new tumours were as well (and they were tiny). It was decided to continue to try BCG and see if it would work.  I have therefore had a maintenance course of 3 and have my next cystoscopy follow up in March.  If it fails again there are various other treatment options including heated mitomycin. 

I had the laser treatment 10 days after my cystoscopy.  With my previous recurrence I had the TURBT within 2 weeks of my cystoscopy.  2/3 months sounds to me an unacceptable amount of time to wait so I would query this and raise with PALS if necessary.