Had my third gem/doc treatment yesterday. I made it through, but I had quite a bit of discomfort. The infusion nurse said many patients terminate the treatment early. I didn’t consider doing that because I want full benefit of the prescribed treatment. Three down and three to go. Good luck to all those on the board.

Thanks very much. I had my fourth treatment on Friday. It was comparable to prior treatments. I am now concentrating on the fact that there are only two treatments left in this initial course of chemo. I am changing physicians immediately after the sixth treatment. My current physician has great qualifications and experience. But he never told me what had been prescribed (turned out to be gem/doc for which I am grateful). He waited until after tumors reappeared to begin chemo. He called me on the phone; he said he had ordered chemo and that I would hear from the infusion center and then he hung up. I sent a MyChart email asking whether it was systemic or intravesical, the duration, and what side effects I could expect, I heard back from his PA. I will add one thing more. Though there is a shortage of BCG, it is available. I have a hunch it is reserved for younger patients. Quite frankly, statistical analysis suggests that, gem/doc as a substitute therapy to be equally effective. But — and it is a big BUT - in order to get into many trials, or be eligible for certain other kinds of treatments, a threshold criterion is that the patient has been prescribed BCG, and that is not effective. In other words, my current physician may have limited future options of treatment. Ask questions.