For recurrent or high-grade superficial TCC in the bladder, which treatment option is commonly used?

For recurrent or high-grade superficial transitional cell carcinoma (TCC) in the bladder, intravesical Bacillus Calmette-Guérin (BCG) therapy is considered a standard treatment option. BCG is a form of immunotherapy that is administered directly into the bladder.

The rationale behind using intravesical BCG for this condition lies in its mechanism of action and efficacy. BCG works by stimulating the immune system to target and destroy cancer cells in the bladder. Studies have shown that BCG is effective in reducing recurrence rates and improving outcomes for patients with high-risk superficial bladder cancers compared to other modalities.

Regarding other treatment options, radical cystectomy, which involves the surgical removal of the bladder, is generally reserved for muscle-invasive bladder cancer or cases where conservative measures fail. Urethrectomy focuses on removing the urethra, which is not applicable for treating TCC confined to the bladder itself. Immunotherapy in a broader sense does encompass options beyond BCG, but intravesical BCG is the most widely accepted and studied treatment for the specific scenario of recurrent or high-grade superficial TCC.