Bladder cancer
Management of BCG-pretreated (very) high-risk NMIBCLogan (73 years old)
Logan, 73 years old, spent years maintaining a remote lighthouse, ensuring ships stayed safe. He was diagnosed with intermediate-risk NMIBC 4.5 years ago and was treated with TURBT followed by intravesical chemotherapy for 1 year.
Follow-up cystoscopy 3 years after the final course of intravesical chemotherapy shows multiple reddish lesions at the anterior bladder wall.
Assessment summary:
- Medical history:
- Former smoker (50 pack years)
- Hypertension, obesity, diabetes mellitus type 2
- ECOG PS: 1
- Urine cytology: HG UCa (according to the Paris system)
On TURBT urothelial CIS was detected. A CT urography ruled out nodal and upper tract involvement.
BCG induction was started and followed by maintenance BCG. CIS is present 3 months after the start of BCG (i.e. BCG induction completed) and persists at 6 months (i.e. first course of maintenance completed).