Bladder cancer
Treatment approaches for patients diagnosed with (very) high-risk NMIBC

Extra case 1: Guilherme (82 years old)

Guilherme, now 82 years old, is a retired carpenter who still enjoys spending time in his workshop, crafting small wooden pieces for his grandchildren.

He was initially diagnosed with low-grade Ta, low-risk NMIBC. He received 1 immediate chemotherapy instillation after TURBT.

Follow-up cystoscopy after 2 years shows a 1 cm papillary tumour. Visual appearance suggests a non-invasive bladder cancer recurrence. Cytology was negative for high-grade disease.

Assessment summary:

  • Former smoker (40 pack years)
  • No haematuria, voiding difficulties or urinary tract infection
  • Comorbidities: hypertension, mild chronic obstructive pulmonary disease
  • ECOG PS: 1
  • American Society of Anaesthesiology (ASA) score: 2

Which option would you choose for this patient?