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Dr. Tharun
Dr. Tharun, Urology Resident
Category: Urology
Satisfied Customers: 3682
Experience:  MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.
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I have been diagnosed with bladder cancer July 2012

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I have been diagnosed with bladder cancer July 2012 Papillary CA
Had 6 BCG treatments plus 2 follow up treatments
FISH test positive April 2013
Had another biopsy. diagnosis Cancer in Situ
What course of treatment would you recommend?

Is the cancer muscle invasive ?

Do you have any medical illness?

How is your general health?

What is your take on surgery ?

Please let me know

Customer: replied 4 years ago.

not muscle invasive

No medical illness

General health good

Don't know what you mean by take on surgery

What path of treatment do you recommend?

Customer: replied 4 years ago.

I'm waiting for a reply

Hi Baila,

CIS or carcinoma in situ is by definition high grade cancer but not involving the muscle layer,which has high chances of progression into muscle invasive disease later.

Going by protocol and guidelines you are a candidate for repeat BCG therapy full course with maintenance therapy.30-40% of people respond to this treatment and are cured.
But you are also a candidate for early cystectomy - removal of the bladder and replacement with a newer urine reservoir.Early cystectomy is recommended in cases where the cancer recur and general health is good to tolerate surgery.The rational for this is that post surgery the survival of such patients is more than 90%. Also some patients are found to have muscle invasive disease on surgery.

Survival decreases if the disease recurs after repeat BCG and then the surgery is done.On the other hand the surgery is a major one and you have to empty your new bladder with a tube regularly.

But as of today; both approaches are justified and you can decide on either one.

I hope this helps you take a decision.


Dr. Tharun and other Urology Specialists are ready to help you
Customer: replied 4 years ago.

What is the success of BCG plus Interferon?


The BCG plus Interferon has been used for BCG failures with reduced dose of BCG.The response rate has been in the range of 40 -50 %.The disease progression has been observed in only 8 % of patients.So there is a role of this combination in your case, but only after the second BCG alone therapy.

But again these options are to be considered only if you are not keen on surgery.