any feedback on Keytruda?

it is good that you gathering information to make an informed decision. While I am not medically trained, I know sometimes even in official sites you need to look at context of data. The 30-40% may be from a small group of people and user reviews referencing organ failure or death might not give case specific information like underlying health conditions. You are definitely doing the right thing though, discussing your concerns and and alternative options with your doctor. Let us know how you get on, on Monday. Laura, Moderator, BladderCancer.net

Hey GNick! I also echo what Laura replied, but I would also like to encourage you to listen to your intuition. That gut, pit of our stomach response is often so correct! I wish we had listened to ours when Mom was fighting her battle. If possible, perhaps a second opinion would give you some peace of mind in your decision? I am not medically trained at all, and my thinking is that DNA-sequencing of cancer cells is necessary for an immunotherapy to be truly effective. I'm wishing you all the best luck!!

Charles, Moderator / BladderCancer.net

I'm closing out this thread with my decision NOT to do any more treatment. Keytruda is intended for difficult cases where previous methods have not worked but has risks that I'm not willing to take. Gemcitabine is an even stronger chemo that *could be* harder on my body than a cystectomy (Dr says it's overkill in my case). Since my tumors are non invasive and well contained, my best chance for recovery is bladder removal. I do not have the will to endure the side effects of chemo, and having chosen to create a neobladder (instead of a stoma/bag) I think my quality of life will be better/faster than further treatment. I will continue posting elsewhere on this forum as work continues.