FOR BLADDER CANCER TREATMENT
Bacillus Calmette-Guerin (BCG) is an intravesical therapy bladder cancer treatment. With intravesical therapy, the doctor puts a liquid drug right into your bladder rather than giving it by mouth or injecting it into your blood. The drug is put in through a soft catheter that’s put into your bladder through your urethra and stays in your bladder for up to 2 hours. This way, the drug can affect the cells lining the inside of your bladder without having major effects on other parts of your body.
BCG is the most common intravesical immunotherapy for treating early-stage bladder cancer. It’s used to help keep the cancer from growing and to help keep it from coming back.
BCG is a germ that’s related to the one that causes tuberculosis (TB), but it doesn’t usually cause serious disease. BCG is put right into the bladder through a catheter. It reaches the cancer cells and “turns on” the immune system. The immune system cells are attracted to the bladder and attack the bladder cancer cells.
WHEN IS INTRAVESICAL THERAPY USED?
Intravesical therapy is commonly used for bladder cancer treatment after transurethral resection of bladder tumor (TURBT) to kill any cancer cells that may be left in the bladder. It’s often done within 24 hours of the TURBT procedure, and some experts say it should be done within 6 hours.
TO TREAT NON-INVASIVE BLADDER CANCER
These cancers are only in the lining of the bladder. They may be called non-invasive (stage 0), or minimally invasive (stage I) bladder cancers, meaning that they have not spread into deeper layers on the bladder wall muscles or to other parts of the body.
Intravesical chemotherapy is used for these early-stage cancers because drugs given this way mainly affect the cells lining the inside of the bladder. They have little to no effect on cells elsewhere. This means that any cancer cells outside of the bladder lining, including those that have grown deeply into the bladder wall, are not treated by intravesical therapy. Drugs put into the bladder also can’t reach cancer cells in the kidneys, ureters, and urethra, or those that have spread to other parts of the body.
One dose of intravesical chemotherapy might be the only treatment needed for non-invasive cancers, as these cancers grow slowly.
Intravesical chemotherapy or immunotherapy may be used for intermediate non-invasive bladder cancers. Some studies suggest that immunotherapy works best. It’s done once a week for 6 weeks, and may be repeated for another 6 weeks if needed. After a 4- to 6-week break, maintenance treatments are then done for at least 1 year.
High-risk non-invasive bladder cancers might be fast-growing (high-grade), big, or there may be more than 1 tumor. They’re treated with induction intravesical immunotherapy. If there’s a good response to induction therapy, it’s followed by 3 years of maintenance intravesical immunotherapy.
Intravesical immunotherapy maintenance treatment schedules vary. For instance, treatment may be done for 3 to 6 weeks every month, every 3 months, or twice a year. It can be done for 1 to 3 years. Your doctor will talk with you about the best plan based on the details of your bladder cancer and how it responds to treatment.
BLADDER CANCER TREATMENT FOR HIGHER-STAGE, INVASIVE CANCERS
One dose of intravesical chemotherapy is done within 24 hours of TURBT. But other types of treatment are usually the next steps for Stage II to IV (2 to 4) bladder cancers because they have spread beyond the lining layer of the bladder wall.
Sometimes induction and maintenance intravesical immunotherapy is used after radiation and systemic (in the blood) chemo for stage II cancers if surgery can’t be done. It’s seldom used for stage III. When it is, it’s used along with other treatments in cases where surgery can’t be done. Stage IV bladder cancers are rarely treated with intravesical therapy.
SIDE EFFECTS OF BCG BLADDER CANCER TREATMENT
Treatment with BCG can cause a wide range of symptoms. It’s common to have flu-like symptoms, such as fever, achiness, chills, and fatigue. These can last for 2 to 3 days after treatment. It also commonly causes a burning feeling in the bladder, the need to urinate often, and even blood in the urine.
Rarely, BCG can spread into the blood and through the body, leading to a serious infection. This can happen even years after treatment. One sign of this can be a high fever that isn’t helped by Tylenol or medicines like it. If this happens, call your doctor right away. You might want to ask about other serious side effects you should watch for and call your doctor about.