G3PT1 - BCG vs Radical Cystoscopy the choice and rationale

It is major surgery and you can’t really prepare for the physical and emotional tiredness that follows.It is a bit of a roller coaster and you can get depressed when the recovery drags on.When I felt better I wondered how I got through it being so ill pre op.Jane 

Cheers Jane, I wonder why many consultant recommend BCG instead of RC for G3 cancers? Budget, groupthink….any ideas?  It must of course work in many cases otherwise they would not recommend it.My consultant, a eminent man in his profession looked me in the eye just before I went to theatre with him recently and said “I do not recommend a radical cystectomy unless you really really need it” Followed my more penetrating looks. Leo

I too had a grade.3 T1 tumour removed in April this year and the 2nd turbt showed no signs of any cancer cells. When discussing the treatment plan with my consultant, he did mention a radical cystectomy but it felt like it was a curtesy mention (possibly because they've got to give you all options available) He and the MDT recommended going down the BCG route and because I was undecided as to how to proceed, he reassured me that they had obtained a good sampling of the bladder muscle during the re-resection and he reassured me that the bcg was the preferred treatment path to follow. I've just completed my induction course of bcg and will have a cystoscope check on 3rd September. I think there's always concerns about whether you've taken the right path but I put.my trust in the medical experts and fingers crossed it right for me. But, I agree, its such a hard choice to make

Anne

Anne, I also agree, you have to trust them. My consultant has 13 other consultants working for him. Must know a thing or two.

5 years since my RC and not been on here for a long time. Good to see some old names on here still around. Many who helped me through some tough times. 

My consultant advised me for an RC rather than BCG with the words I always remember "you don't want to miss the boat". It really is a rough ride but so glad I did it. I do remember on the morning meeting the other consultants who are part of the relay team doing the RC as it's such a big op. 2 asked me why didn't I go BCG route so it really depends on that consultant point of view I feel.

Like I say 5 years on and just had my first cystoscopy of my neo bladder and all good still. I think only real downside I found was the erectile dysfunction and still mentally and of course physically struggle with that . Just keep thinking though how lucky I am though.

Good luck Leo1 and you just have to go with what you feel is best and take the advice on board.

Cheers Lugsy, if BCG does not work out in 1st year or I get fed up with the palaver of the treatment, I will seek surgery.

Hi Lugsy,Good to hear from you and that you are doing well.Best wishes Jane x

Hi Jane , good to see you are still on here and well done for all the help you and advice you have provided Hope life's all going well for you. 

Thanks Lugsy,I was a few months behind you with the cystectomy.Currently cancer free so very grateful for the surgery.Jane x

That's a pity if people sound dismissive of BCG. It can certainly cure in some cases  and not everyone has bad side effects. For some people, it is absolutely the right choice, for all sorts of reasons. 

RC is certainly not to be taken lightly, and obviously has risks & side effects of its own, but for some there is no choice. Those of us who have been through it are aware that the anticipation is often worse than the actual event, which perhaps makes us gloss over the experience.