Bruce (63 years old)

Bruce, 63 years old, is the coach of the women’s lacrosse team in his village. This year, they haven't won a game yet.

He presented with macroscopic haematuria, which led to the discovery of a high-risk NMIBC. After the first cycle of 6 instillations of BCG, he relapsed.

Assessment summary:

• Former smoker (50 years)
• Medical history: gastroesophageal reflux
• Family history: sister with thyroid cancer
• Creatinine level: 91 µmol/l, eGFR: 78 ml/min
• Pathological report TURBT:
  • High-grade papillary UCa
  • Muscle in specimen, free of tumour
  • pT1b without CIS
  • No FGFR alteration
• CT scan of thorax/abdomen/pelvis: no distant lesions or synchronous UTUC
• Robot-assisted laparoscopic cystectomy + PLND:
  • Urinary diversion by ileal conduct
  • Pathology report: pT2 + CIS on prostatic urethra N0 (0/37) R0

Surveillance with routine imaging with CT of the thorax and abdomen is planned for this patient. Vitamin B12 levels will be measured annually.