David is a 71-year-old amateur golfer. Despite the closing of the golf club due to the COVID-19 pandemic, he enjoys playing a game in his 8 square meter garden using a miniature golf set.
He was diagnosed with non-muscle-invasive bladder cancer (NMIBC) 3.5 years ago. Control cystoscopy 18 months ago showed again a papillary tumour. He underwent TURBT and re-TURBT.
- Single high-grade pT1 tumour of 3.5 cm in the first resection
- No evidence of disease after the second resection
- BCG instillations for 1 year
- Follow-up with cystoscopy and cytology every 3 months
Since his last follow-up 3 months ago, healthcare systems are overloaded due to the COVID-19 pandemic. The patient cannot visit the hospital due to cancelation of appointments. His next appointment can be scheduled the earliest in 2 months, which is 5 months from his last cystoscopy.
However, the urologist is concerned and the patient is anxious about delayed follow-up.
Which option would you choose as a next step for this patient?
Cast your vote and see what Prof. Dr. Morgan Rouprêt recommends for this patient case!
Delayed cystoscopy
Continue follow-up with cytology alone, without hospital visits
Urinary biomarker test now and, if negative, cystoscopy in 3 months; if positive, expedite the cystoscopy