Bladder cancer
Challenges in high-risk NMIBC

Morgan (75 years old)

Morgan, 75 years old, masters as many languages as his age. He tries to keep up with this record by learning 1 new language every year.

Assessment summary

  • Comorbidities:
    • Arterial hypertension
    • Peripheral artery disease (PAD)
    • Former smoker (40 pack years)

Workup of painless haematuria showed a tumour on the right bladder wall. He underwent TURBT: pT1 HG, muscle in specimen. After second resection, there was no evidence of disease. BCG was given for 1 year.

15 months after completion of BCG, he has recurrent disease. TURBT shows again a pT1 HG tumour (diameter 1.5 cm, no LVI). A second resection again shows no evidence of disease.

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