Radical cystectomy Vs BCG treatment choice with aggressive non-muscle invasive bladder cancer

My husband had stage 3 muscle invasive bladder at age 63. In October 21 he had radical cystectomy but because he was otherwise healthy he could have the neo bladder. Whilst removal they remove lymph nodes 1 was found cancerous so 6 months after op he had chemotherapy.  Very unpleasant.  I would definitely have a good 6 months off for recovery.  A lot of looking after of the new bladder originally.  But he has made a full recovery new bladder is amazing.  He's off to golf tomorrow. He has regular CT's . The care he was given was amazing. Now he is back to normal we count ourselves very lucky x

Hi Hopeful786,My sister asked the surgeon whether I would be cured with cystectomy.He said there were no guarantees but he would do his best.I remain hopeful that I’m cured.Jane 

Hi All

My cancer was G3T1 (2 tumours with one over 3cm) At my second TURBT where muscle biopsies were taken from the original surgery sites NO cancer cells were detected. I was offered early RC but after long discussions with my surgeon who has a pHD in Bladder Cancer I have opted for BCG with close monitoring. My surgeon has assured me that even fast growing aggressive tumours grow slowly at about 1cm per year so with close monitoring of Cystoscopy, PDD scan and CT any further tumours would be caught early and dealt with through TURBT. Without the security of close monitoring I probably would have opted for the RC. Also as a female I did not want to lose my uterus, ovaries or my urethra during the surgery. I've got 2 more of my induction BCG to go and then a check cystoscopy at the end of July. Hoping for a nice clear scan.

Not an easy decision for anyone on the forum.

Best wishes to all whatever your decisions are.

Love Ade xx

Thanks Teasswill

Lies, damn lies & statistics!  

Thanks Teasswill

Really useful information re recovery. I’m hoping to bring forward my optometry career retirement; ideally sell the business in the next couple of years.

Indeed! The main problem is not knowing what group you will fall into. One day, they will be able to get sufficient info from the first biopsy to tell which cancers are likely to respond well to BCG & which not. 

I don't wish to spread doom, only a sense of reality so that people can make informed decisions. I am still highly sceptical of the claims that patients quote from their consultants, that surveillance will guarantee to catch recurrences before they become muscle invasive. This is not borne out by patients, nor by research papers. 

Thanks Kim

Really good advice. Glad your husband has fully recovered; brilliant news!!

Sounds a good plan to enjoy an early retirement. At least the profession is one in which you can easily work part-time if you wish. 

Do you have some plans for activities in retirement? 

Thanks Ade

  for continued clear scans for you. Absolutely agree with you - there isn’t an obvious same correct treatment option for everyone; just depends on individual histology findings.

Hi Teasswill

Probably a seaside cottage on the North Yorkshire Coast - lots of coastal walks, healthy sea air (ideally Whitby), combined with maybe 1 day a week working, just to supplement living expenses.