Does anyone know of treatments more effective than BCG?

I think studies have shown that Gemcitabine/Docetexal combination is at least as good and is being used when BCG is not available. I have gone through the induction period and have had two instillations of the 12 month maintenance. My cystoscopy and urinalysis after induction were clear. My diagnosis is Ta, high grade, NIMBC, CIS. I have had next to no side-effects.

Thank you very much for this information. It is very helpful. All the best to you!

Nine years ago I had 3 high grade, aggressive, non invasive tumors removed followed by a series on BCG treatments. A year later we were doing it again as the cancer had return. Since then I've been scoped every 6 months and I've had several more tumors removed. In April 2024 I had my right kidney, ureter, and a small section of my bladder removed due to cancer.
I had another tumor removed in late January and am scheduled for another scope on May 4. Doctor is talking about starting me on Gen/Doce since BCG doesn't seem to work for me.

And to @gendoc25, thank you for sharing your experience. It is encouraging to hear that you have experienced next to no side effects with Gen/Doce!

@pol7
As an addendum, which I’ve mentioned elsewhere, after my initial TURBT, the pathology slides were analyzed by a AI system called Vesta, from Valar Labs, which determined that BCG would not work for me. Hence the choice of Gem/Doce.

Dear Paul-- Thank you for this addendum. I've had two TURBTs and a second opinion on the first path report was diagnosed high grade non-invasive-- while my own doctor's assessment was low grade--and neither party could explain the discrepancy. The second path report was assessed by both organizations and indicates I have "intermediate" grade and higher risk but still non-invasive cancer. My doc. had a vesta test done on my second path report which simply said I had a slightly higher risk of it progressing than average (whatever that means)--but my doc said this was the first time he had heard of the company and their tests. When asked he also said vesta does not test for the potential of BCG working with low or intermediate grade bladder cancers.

Do you know if Valar Labs has data on how accurate their vesta test is? And might you know if, when asked, they perform it on "intermediate" grade cancer?

Thanks very much---and all the best to you.

Hi,
I can’t be very helpful with data, but I would refer you to the Valar Labs website and suggest you contact them directly.
Here is some more information at
http://www.urotoday.com/library-resources/bladder-cancer/154310-gem-doce-in-2024-what-is-next.html
The original studies were done at the University of Iowa. Google university of Iowa gem/doce.
I hope this helps. Happy reading😊

@gemdoc25 This is eye opening information . I have never heard of Valar Labs or the Vesta testing. How did you get this done? Unfortunately I am in the midst of a very frustrating care team at the Cleveland Clinic. They had never heard of Natera or Bio marker testing. I am getting 2 second opinions and definitely will bring this up. Thank you in advance for any insight you can provide. I wish you well along your continued journey.

@gemdoc25 thank you! I did visit their website and will be bringing this up with my 2 second opinion facilities. Again, many thanks!

@dopps
I had not heard of Valar Labs until now. I'll look into it.

Hi @michzn,
I am being treated at Moffitt Cancer Center, Tampa, FL. The uro/oncologist had the pathology analysis done. I had never previously heard of Vesta and there was no discussion beforehand except to say the sample had been sent off and I would have to wait three weeks for the result, from which biomarkers indicated that BCG would not work for me. I'm pleased with the choice of treatment, so far.
I'd like to correct my diagnosis from a previous post: it's Ta, high risk, NIMBC, CIS, not high grade.
Thank you for your kind wishes and I wish you the same.