Peter, a 72-year-old retired engineer, was diagnosed with T1 high-grade (HG) non-muscle-invasive bladder cancer (NMIBC) 18 months ago. Following a successful transurethral resection of the bladder tumour (TURBT) and re-TURBT without further pathology, he received a full induction course of bacillus Calmette-Guérin (BCG) therapy followed by maintenance BCG.
At his initial 3-month follow-up cystoscopy, he was confirmed disease-free. According to standard guidelines for high-risk NMIBC, Peter’s surveillance schedule involves frequent cystoscopies and urinary cytology every 3 months for the first 2 years.
During his next follow-up visit, Peter raises that these frequent, invasive cystoscopies cause him significant anxiety well ahead of each appointment. The continuous need for hospital visits also disrupts his otherwise active retirement, adding a considerable burden to his daily life. Moreover, he experienced a urinary tract infection (UTI) following last cystoscopy leading to delay of maintenance BCG instillation.
Cast your vote and see what Prof. Prof. Jørgen Bjerggaard recommends for this patient case!
Continue with routine, frequent cystoscopies
Alternate urinary biomarker with cystoscopy; performing an earlier cystoscopy only if the urinary test yields a positive or unconclusive result
Discontinue all regular surveillance visits, relying solely on symptom-driven investigations for recurrence