FYI, the current protocol for treating CIS in North America is at least the completion of the 5-6 weeks of the BCG induction course, which you are being treated with, plus 2-3 weeks of the maintenance course after 3 months of the induction course. The BCG treatment is known to have an enduring effect, especially on CIS. Dr. Ashish Kamat of MD Andersons Cancer Center in Texas points out that based upon a clinical study, the complete response rate of the BCG treatment for CIS was 55% upon Cystoscopy 3 months after the completion of the BCG induction course, but the complete response rate improved to 84% after the 3 weeks maintenance course. Even without the maintenance course, the complete response rate improved by 10-15% by 6 months. This protocol is not explicitly mentioned in the American Urology Association (AUA) guidelines for non-muscle invasive bladder cancer, neither it is mentioned in the European Association of Urology (EAU)guidelines. I do not know the protocol in the UK if it includes cystoscopy at 3 months after the 6 weeks induction course. What Dr. Kamat is saying is that for CIS-only patients, continue the 3 weeks maintenance course even if a recurrence is found at 3 months after the 6 weeks induction course rather than starting alternative treatment such as Mitomycin treatment, which is often administered to BCG unresponsive patients in the UK.
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