Thanks Alan, Your reply makes perfect sense. I've never smoked and my general health is very good with a pretty high physical fitness level. The tumor three years ago was a TA with high grade cells. I only ask this because I recently had a negative cytology but a suspicious cysto three years after my original diagnosis. The plan is to scape the suspicious area, which apparently is very near the original tumor site and biopsy it. I am puzzled about one thing though: My urologist says he's going to install gemcitabine after the area is scraped BEFORE the biopsy. I just don't understand why the gemcitabine will be installed now instead of after the first TURBT, and especially, why now before the specimen is even biopsied. You're spot on in your answer dealing with trust in the medical team, and I appreciate it that you reminded me of this.