Hello @hummelb99. Sorry that you need to be a part of this group. My husband has been on this bladder cancer journey for 6 years. His urothelial cell carcinoma was highly aggressive and muscle invasive so it kept recurring. He was a BCG failure, Keytruda failure, but did not have the options available even now so chose surgery with bladder removal and neobladder. He is cancer free now. You will have more treatment options with non muscle invasive tumor, but the darn things like to keep coming back. You have been through a lot already. Just know that it never hurts to ask for a referral for a second opinion at a larger cancer center, if needed. Be strong. You can get through this.