Hi and welcome,
As you saw from the responses, some people are surprised that BCG was offered for a low grade tumor, but I suspect that the size of 5cm was the dr's rationale as the guidelines would put anything over 3cm in a slightly higher risk category. There is a difference between risk of recurrence vs. risk of progression. As your risk of progression is very low, the doctor figured BCG would lower your risk of recurrence. Some would say overkill, others not.
If you are happy with your doctor's decision to err on the side of caution, then that's a good reason to have the treatments. But I do wonder about the necessity of maintenance therapy, the extra 3 doses every 3 months (which may go on for years, Dr. Lamm's maintenance protocol can be found here
blcwebcafe.org/drlammsprotocol.asp
).
In Europe-which is historically less aggressive regarding BCG maintenance therapy, maintenance is reserved for CIS (carcinoma in situ, an aggressive type of 'flat' tumor), because that is a high risk for progression. Extenden maintenance schedules have been shown to increase survival in these cases, but not for low grade tumors. In the case of maintenance BCG for a low grade, single tumor of 5cm, most doctors would call this overkill, I'm pretty sure.
About the PSA levels, that could be a side effect, I sure hope so!
From Webcafe's page on BCG:
BCG and PSA
A study published in the November 2000 issue of the Journal of Urology showed that used of BCG can raise PSA (prostate specific antigen), and that intravesical BCG therapy is associated with significantly elevated PSA in up to 40% of cases. The authors state: "This effect is self-limited and PSA reverts to normal in 3 months. Therefore, we suggest that prostate biopsy be withheld in such patients and PSA monitored." 13 2003: "Endovesical BCG administration produces an increase on serum PSA levels. This variation is higher in patients with history of TURP." 15
A very interesting tool for calculating risk of recurrence and progression, can be downloaded free:
www.eortc.be/tools/bladdercalculator/default.htm
I ran your diagnosis by it and your probability for progression was almost none.
Best,
Wendy