Gee Andrew...get a copy of that pathology report.....Stage 2 also invasive into the muscle.
Indianapolis has one of the finest university affliated bladder cancer institutions...its now Clarion Health...formerly I.U. Medical...They have top rated uro's including Dr. Koch who invented the Koch pouch...and the Indiana pouch invented there. You might want to seek him out for a second opinion..............
www.clarian.org/portal/patients/findadoctor?paf_gear_id=300006&paf_dm=full&paf_gm=content&task_name=displayBio&contactId=109421.
As for BCG reactions...and all the things you don't want to know!
Complications of BCG Intravesical Therapy
Intravesical BCG presumably stimulates an immune response to the tumor and thus is associated with unique side effects. Dysuria and urinary frequency are expected as a consequence of the inflammatory response, and cystitis is the most frequent adverse reaction-occurring in up to 90% of cases66,67. Hematuria may occur with cystitis and is seen in one-third of patients67. Irritative bladder symptoms are unlikely in the week after the first intravesical BCG67. Side effects of BCG generally increase with successive treatments, unless the dose of antibiotics is reduced or prophylactic antibiotics are given. Patients with symptoms lasting more than 48 hours can be treated with 300mg INH daily70. This treatment is continued only while the symptoms of hematuria and cystitis persist and is reinstituted one day before subsequent BCG instillation and continued for three days. According to Stassar and associates41, INH does not impair the local immunological stimulation after intravesical BCG or the efficacy of BCG. BCG treatments are postponed until all side effects from previous instillations have resolved. BCG is a live organism, and even though virulence has been dramatically attenuated, regional or systemic infection may occur. BCG organisms usually are gone within a few days of instillation but have been reported to persist in the urinary tract for at least 16.5 months after intravesical BCG69. Initial estimates of the incidence of BCG sepsis were in the range of 0.04% and 10 patients died following intravesical BCG66. The incidence of sepsis has dropped dramatically after the precaution of not administering BCG after traumatic catheterization or in the presence of continued symptoms of BCG infection. When BCG sepsis does occur, we now recommend INH 300mg, rifampin 600mg, and prednisone 40mg daily. Prednisone is continued until sepsis abates and is then tapered gradually over the next two to four weeks. Rifampin and INH are continued for three to six months, depending on the severity and duration of the reaction. Animal studies68 have confirmed that this regimen significantly improves survival and no patient receiving this regimen has died of BCG sepsis. The diagnosis of BCG sepsis is made by clinical presentation with high fever, shaking chills, and then hypotension. It is important to proceed with antibiotic treatment without waiting for culture results when systemic BCG infection is suspected. Typically, cultures are negative, even in the face of clinical sepsis. Molecular techniques to identify BCG DNA may prove useful in the future70