With BCG in short supply and recurrence rates still high, the race is on for better intravesical options. In this episode of BackTable Tumor Board, Dr. Lindsey Herrel, urologic oncologist at the University of Michigan, joins Dr. Ruchika Talwar to explore the evolving landscape of intravesical therapy for intermediate risk bladder cancer. --- This podcast is supported by an educational grant from UroGen Pharma. --- SYNPOSIS The doctors break down the nuances of defining this risk category and the clinical gray zones that complicate treatment decisions. Dr. Herrell shares her patient-centered approach to surveillance and therapy, and introduces promising new agents, including Anktiva, UGN-102, and the gemcitabine-releasing TAR-200 "pretzel" device. The discussion also highlights how advances in molecular profiling are reshaping care strategies.This episode underscores the urgent need for clearer guidelines and continued innovation to improve outcomes and quality of life for patients with this nuanced disease subtype. --- TIMESTAMPS 00:00 - Introduction02:03 - Defining Intermediate Risk Bladder Cancer06:12 - Intravesical Therapy Options08:47 - Quality of Life and Patient Counseling10:18 - New Treatments on the Horizon12:56 - Practical Tips for TURBT Recovery17:03 - In-Office Procedure Management21:38 - Managing Symptoms and Quality of Life31:50 - A Note on Smoking Cessation33:37 - Conclusion and Future Directions