Hello,
My husband had a grade 3 recurrence last year (having had an initial diagnosis of pTa, G3 around 2.5 years ago) and has had BCG reinduction (6 treatments). He is due to have a ri gid cystoscopy with biopsies in a couple of weeks. His total number of BCG is now 18 as he had 12 after his original TURBTs. I wonder if anyone has any idea what is likely to happen next, assuming his biopsies are clear? I have read a couple of times on this forum that 90% of BCG benefits are in the first year. Does this mean that this reinduction won't make much difference, or because he has been reinducted after a year or more without BCG that he will get a big boost from this? He wasn't given any indication of whether they will do more maintenance or if this will be it again. The consultant had suggested he would be having a cystectomy if the recurrence was G3 but he was offered the alternative of more BCG which he took. I have lost a lot of my optimism that he would be able to move on from this for at least a reasonable period of time - it's hard to know if this recurrence is not unusual or a sign that he is on a downward spiral. He is back on 3 mth checks for another two years - makes it very hard to plan with any certainty.
Hi Catfan . It's always frustrating when things aren't explained well enough. Not had BCG but reading many posts over the years it seems treatments are tailored to the individual after the initial course. Hopefully someone with experience will be along to help. I hope all goes well. Best wishes.
I was also TaG3 initially. My surgeon told me that of those choosing BCG, 70% would be clear after first tranche of treatment, but 50% would need cystectomy in the long term. Unfortunately BCG doesn't always cure, it may simply delay recurrence/deter progression. Witha recurrence, some consultants seem happy to re-set the clock & start BCG all over again, or try an alternative eg mitomycin. Some would advocate surgery to forestall a muscle invasive recurrence which could become incurable.
Once the biopsy results are in, your husband should have a consult to discuss treatment options. Important to ask pros & cons, risks & benefits etc Best wishes.
Thanks Teasswill - that's helpful. His consultant has always been quite keen on cystectomy but I think at the beginning the CT scan was suggestive of muscle invasion which would explain that. He also said when my husband was in for his latest TURBT that he would need 'more serious surgery' if histology was high grade. When he saw a different consultant for results he was offered a choice of either surgery or 6 more BCG - I wasn't there to ask about pros and cons. They know he doesn't want cystectomy so perhaps didn't push it. I feel very stressed by the constant fear of recurrence and the frequency of follow up but it's not my decision. I guess if he has another recurrence he may change his mind. The nurse specialist said they are treating it aggressively as he is at the young end of the spectrum and can tolerate it.
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