@nancic , my experience has been the same. In my case,original ct scans never showed that the cancer was locally advanced outside of the bladder. I switched from a NJ community hospital after a Turbt and a second opinion. My new team of doctors at a major NY teaching hospital made that determination. I have been a Signatera “fan” ever since. When my high risk/ aggressive cancer returned this spring after being undetectable for 1 year , it again was too small to show on a CT scan. My oncologist ordered a pet scan and started chemo again achieving another full response after 4 cycles. So far so good with latest Signatera on Jan 8 still undetectable.

@nancic, are you currently on treatment for recurrent bladder cancer? How are you doing?