Bladder cancer
Low- and intermediate-risk NMIBC: surveillance or intravesical therapy?

Daniel (66 years old)

Daniel, 66 years old, enjoys his life as a free man after his retirement 1 year ago. He never really liked his job. Now he is trying new hobbies to find out what his passion is. Last week he went fishing but stopped after an hour because he was already bored.

He visits his doctor because of painless haematuria.

Diagnostic work-up

  • Cystoscopy: 1 papillary tumour at the right bladder wall, 4.5 cm
  • TURBT with random bladder biopsies:
    • Visually complete resection
    • pTa high-grade (HG)
    • No CIS
    • Muscle present in specimen
    • No LVI

BCG instillations at standard frequency and standard dose are not an option due to short supply.

Which of the following treatment options would you choose for this patient?