Patient Case and Treatment Fundamentals

This segment introduces the patient case that anchors the program: an older retired teacher originally diagnosed with a low-grade Ta bladder tumor after noticing blood in his urine. He underwent transurethral resection of bladder tumor (TURBT) with a single dose of intravesical chemotherapy and later needed repeat resections for recurrences. He now faces another recurrence with small multifocal low-grade tumors and is frustrated by repeated surgeries and anxious about anesthesia. Based on National Comprehensive Cancer Network (NCCN) and American Urological Association (AUA) guidelines, the panel classifies him as intermediate risk. The faculty then review treatment fundamentals: TURBT, sometimes followed by a single perioperative chemotherapy dose to prevent early recurrence from floating tumor cells. Traditional management added adjuvant intravesical gemcitabine, gemcitabine plus docetaxel, or bacillus Calmette-Guérin (BCG). The segment closes on reverse thermal mitomycin gel, a chemoablative option that destroys tumor cells rather than removing them surgically.