Bacillus Calmette-Guérin (BCG) is a vaccine used to treat bladder cancer and is administered directly into the bladder through the urethra. It is a weakened form of the tuberculosis vaccine that stimulates the immune system to target and destroy cancer cells. BCG is a form of immunotherapy, with localized anticancer effects and primarily local side effects. It is often used in conjunction with other treatments as part of a comprehensive strategy to eradicate cancer tumours in the bladder.
Bacillus Calmette-Guérin (BCG) Therapy for Bladder Cancer
What is Bacillus Calmette-Guérin (BCG) treatment?
How is BCG administered and how does it work?
BCG treatment involves weekly instillations for six weeks, typically starting a few weeks after Transurethral Resection of Bladder Tumour (TURBT) surgery. The solution needs to be in contact with the bladder lining to be effective, requiring patients to change positions periodically during treatment. After instillation, patients hold the solution in their bladder for two hours.
When is BCG therapy used?
BCG is primarily used to treat high grade Non-Muscle Invasive Bladder Cancer (NMIBC) and Carcinoma In Situ (CIS) to reduce the risk of recurrence or spreading. It is administered after all visible tumors are removed through TURBT and the bladder has healed. Due to the live bacteria used in BCG, precautions are taken to minimize the risk of contamination during disposal.
What are the benefits of BCG?
Benefits of BCG treatment include:
- Its non-invasive nature
- Bladder saving potential
- It does not require simultaneous use of other medications to be effective
- Its ability to target cancer cells while sparing healthy ones
What are the side effects of BCG?
Side effects of BCG treatment include:
- Burning sensation during urination
- An increased frequency or urgency to urinate
- Fatigue
- Mild fever, achiness, and nausea
Severe reactions are rare but can include pain, inflammation, and bleeding. If any of these symptoms occur, be sure to contact a medical professional immediately.
Please note that the cumulative nature of BCG’s side effects often results in an escalation of symptoms as the treatment advances.
Tips for BCG Treatment
- To manage leakage concerns after treatment, consider using an incontinence pad.
- To reduce infection risks, shower after urinating for the first-time post-treatment and wash clothes in hot water.
- Frequent urination helps prevent bladder issues. As BCG can be infectious, sit while urinating and double-flush the toilet to safely dispose of BCG in the urine. Alternatively, add 1-2 cups of household bleach to the toilet and let it sit for 15 minutes before flushing.
- If you have dental appointments involving implants or gum surgery that may involve bleeding sites, consider delaying your dental work to avoid potential BCG bacteremia and secondary infections in the healing tissue. Speak with your urologist before any dentistry procedures.
Navigating Bladder Cancer with Bladder Cancer Canada
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