An 86 yr old patient with superficial low grade bladder tumor that was resected and treated with six sessions of BCG therapy in 2009 has had a recurrence in May 2016 with tumor mutation into superficial high grade bladder and resected and treated with BCG for only three sessions and was stopped as granulomatous inflammatory response to the bowel has occured. Tumor has recurred again in September 2016 reaching Muscularis propria without spreading into other organs as per CT scan results.
Is BCG therapy for a high grade bladder tumor that has reached Muscularis propria is recommended.
Otherwise, what is the most appropriate course of therapy
Best