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Bladder TCC pT1 HG, post BCC recurrence pT1 HG

Posted by ioamich @ioamich, Jul 17 11:52am

A 70-year-old man with diabetes who smokes 10–15 cigarettes per day after episode of haematuria was initially diagnosed with bladder transitional cell carcinoma (TCC) following a TURBT on 6 October 2025, which revealed pT3 high-grade disease.

A repeat deep TURBT and bladder biopsies performed in December 2025 showed no residual tumour. He subsequently received a six-week induction course of intravesical BCG. However, surveillance cystoscopy demonstrated recurrent bladder tumour. A further TURBT again revealed pT3 high-grade disease.
A recent CT scan Cest abdomen and pelvis showed no metastasis.
Would you consider offering a second six-week course of BCG, or would you recommend proceeding to radical cystectomy?
Thank you
Best Regards

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Mentor
Sue, Volunteer Mentor | @sepdvm | Jul 18 8:25am

Hello @ioamich. We are all just patients with our own experiences and can’t give medical advice.
My husband with a highly aggressive muscle invasive TCC was declared a BCG failure when tumor returned during maintenance BCG. He was offered Immunotherapy and tried Keytruda. He ended up choosing radical cystectomy aiming for a cure. So far so good. Others have seen success with Gem/Doc protocol. Are those the only two options offered to you? Maybe a second opinion is warranted.

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ioamich | @ioamich | Jul 18 5:09pm
In reply to @sepdvm "Hello @ioamich. We are all just patients with our own experiences and can’t give medical advice...." + (show)
Profile picture for Sue, Volunteer Mentor @sepdvm

Hello @ioamich. We are all just patients with our own experiences and can’t give medical advice.
My husband with a highly aggressive muscle invasive TCC was declared a BCG failure when tumor returned during maintenance BCG. He was offered Immunotherapy and tried Keytruda. He ended up choosing radical cystectomy aiming for a cure. So far so good. Others have seen success with Gem/Doc protocol. Are those the only two options offered to you? Maybe a second opinion is warranted.

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Hello @sepdvm, thank you for sharing your husband's experience with me and for advising properly. It is greatly appreciated.

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Moderator
Colleen Young, Connect Director | @colleenyoung | Jul 29 7:25pm
In reply to @ioamich "Hello @sepdvm, thank you for sharing your husband's experience with me and for advising properly. It..." + (show)
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Hello @sepdvm, thank you for sharing your husband's experience with me and for advising properly. It is greatly appreciated.

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@ioamich, what did you and your team decide to do as a next treatment option?

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