TURBT and Adjuvant Intravesical Therapy Options

This segment reviews standard management for newly diagnosed intermediate-risk non-muscle invasive bladder cancer. The faculty describe transurethral resection of bladder tumor (TURBT), in which the tumor is removed with an electrified loop and deeper tissue is sampled to assess invasion. For low-grade disease, guidelines recommend TURBT plus a single dose of intravesical chemotherapy shortly after surgery to kill residual floating cancer cells. Because the chemotherapy is not given intravenously, it avoids typical systemic effects, but the panel notes its benefit in preventing recurrence is modest. The discussion then turns to adjuvant intravesical options: gemcitabine alone, gemcitabine plus docetaxel, and bacillus Calmette-Guérin (BCG), a live weakened bacterium that triggers an immune response in the bladder. The faculty also address the ongoing BCG shortage, which stems from production plant failures and a lengthy, fragile manufacturing process.