Have you had just one tumor in the beginning? How big was it? If it was < 3 cm and only one. That makes difference in determining how a urologist deals with your treatment. Listening to what you said, I believe your tumor was TaLG, which is good because it is very rare to progress beyond the basement membrane to the connective tissue. The attached chart is the algorithm which most urologists use to determine the treatment for non-muscle-invasive bladder cancer. If your first tumor was single and < 3 cm and TaLG, your treatment is the most left side of the chart. You had 1 recurrence in 1.25 year. It is not too bad. TaLG is known to have high recurrence rate. A case in point, below is the result of TaLG recurrence and the treatment by Memorial Sloan-Kettering Cancer Cener in New York. Please note that the study included TaLG > 3cm and mutiple TaLGs.
They did not use BCG or Intravesical chemotherapy. Just TURBT, Fuguration ( remove mm size in the office not in OR like TURBT) and cystoscopy. If you notice, one patient had 19 recurrence within 8 years. Still they did not use BCG or Intravesical chemotherapy.
The result of study
Of the 215 patients 143 (67%) had at least 1 recurrence (positive cystoscopy). With a median followup of 8 years tumor recurrences averaged 6.2 (range 1 to 19) requiring 0.34 transurethral resections per year or 1 transurethral resection every 3 years, or 0.61 fulgurations or 1 fulguration approximately every 2 years. There were 17 patients (8%) who had progression in grade or stage and 1 patient (0.5%) died of bladder cancer. Patients most likely to have recurrence had multiple tumors, low grade (TaLG) carcinoma or tumor at first followup cystoscopy.
Conclusions
Surveillance cystoscopy at 6-month intervals coupled with outpatient fulguration controls recurrent tumors and reduces the therapeutic burden for patients diagnosed with low grade papillary bladder tumors.
The link to the study
www.sciencedirect.com/science/article/abs/pii/S002253470701419X#!
The cause of recurring NMIBC.
One theory is that when your urologist first removed the tumor, some cancer cells fell on to other places in the bladder. The other theory is field change or also called field cancerization, by that it means that the entire wall of bladder have been exposed carcinogen over many years so it has become easier for cancer to grow. I wonder if your urologist administered intravesical chemotherapy - usually mitomycin right after the first time the cancer was removed. It is known to reduce future recurrences by 8-10%.The intravesical chemotherapy is supposed kill the caner cells which were implanted from the surgery to remove the original cancer (TURBT). My urologist at a local clinic did not do it. If I had gone to a large cancer center, I might have got it.