Yes, that's true and now I wonder just how long this approach goes back. I also have references from Lamm raising questions about the long term *risks* of intravesical chemo, also a reality. The new guidelines are now advocating intravesical chemo for every TUR (unless there is suspicion of perforation or very deep resection done). It reduces recurrences and that saves money and reduces patient morbidity. I suppose the balance is between the side effects of repeated TURs against risk of side effects from the treatment.
I think I'm glad my sister never received intravesical chemo after her dx of Ta, G1 in '98, or after her recur, because that was the end of it. She's been clean since with no treatment. But...if she had been recurring as often as you, or so many others I know, I suppose I would looked on more as a blessing and forget about the possible (not probable) risks.
Well, phew, Rosie, you are a pioneer, I have not met anyone else brave enough to 'watch and wait' with a low grade papillary, but have read the reports about the safety of this, and heard experts discussing it at conferences. It's a valid approach with science to back it up. I hope it pans out well for you and others who may qualify.
As for using the laser, I've seen so many have good long term results in your setting (single, recurrent low grade papillary tumors)I am sure it will soon be in the guidelines as a recommended and safe approach.
BTW, have you noticed lately how articles on the subject of non-invasive, TA, low grade papillary tumors that do not recur after X amount of time can have follow up cystos extended to 5 years?
All the best to you!
Wendy