Mike,
I am a bit ahead of you on this path. I offer two articles as a starting point toward (MY) making an informed but questionable decision.
I had a hard facts discussion with the doc, including the nuances of the biopsy results (first clear, then new or remaining CIS) about how long to try to save the bladder before going the RC route. My concerns include the high percent of RC's that prove invasive when examined after removal. My desire is treat as long as the (presumed) chance of undetected invasion is low.
Based on much journal research and, most importantly, the findings in MY situation, I chose to go for a second course of BCG with follow ups. I am two months away from the next scope, CT and TURBT, which will either make the next decision easy or restart the risk assessment of how long to treat.
Tough decision with a lack of authoritative research applicable at the individual level.
Best
Jack
Can Urol Assoc J. 2009 Dec; 3(6 Suppl 4): S199–S205.
PMCID: PMC2792453
The management of BCG failure in non-muscle-invasive bladder cancer: an update
www.ncbi.nlm.nih.gov/pmc/articles/PMC2792453/
Adv Urol. 2015; 2015: 656918.
Published online 2015 Oct 13. doi: 10.1155/2015/656918
PMCID: PMC4621325
The Role of Interferon in the Management of BCG Refractory Nonmuscle Invasive Bladder Cancer
www.ncbi.nlm.nih.gov/pmc/articles/PMC4621325/