@divey it is easy to get depressed dealing with cancer. Bladder cancer especially likes to return. My husband was a BCG failure and was then offered Keytruda which also didn't prevent recurrence. This has been in the past 6 years, and since then there are new drugs and combinations to try. My husband elected a radical cystectomy with neobladder after 3 years of attempted control and is content with his decision. It looked like the best way to get a cure with his highly aggressive muscle invasive cancer.
As for the insurance fiasco, that is total frustration. You can request for your doctor to do an appeal when a treatment is declined. It is sad that our medical professionals must waste their time dealing with insurance decisions made my non-medical uneducated personnel. Keep treading water as there are new treatments being approved and more research being done. Look for the things that make you happy and have gratitude for them every day. It helps to keep the attitude positive. Though it feels like your life is on hold as you battle cancer, you really must concentrate on keeping something positive in your life, no matter how small.
I hope someone who has experience with this treatment will comment here.

@divey i am new to this unwished for group. God Bless and cure all of us. My Dr. did say something about that pretzel thing. I am having cystoscopy after surgery removal of tumor. then they will decide if BCG is worth it or do i go straight to chemo. Guess that's the pretzel. Again my prayers and huge hugs to all.