Your doctor may prescribe some of the following treatments to help prevent the cancer from recurring.
NONMUSCLE-INVASIVE BLADDER CANCER TREATMENT
TREATMENT WITH BCG
Once the bladder has healed from your diagnostic TURBT, a second TURBT may be performed within about six weeks if the tumour was aggressive. A drug called BCG (Bacillus Calmette-Guérin) may be inserted into your bladder through a catheter once a week for about six weeks (intravesical therapy).
BCG is a weakened form of the tuberculosis mycobacterium which stimulates immune responses within the bladder to destroy the cancer cells.
You’ll hold the BCG inside your bladder for up to two hours. Medical facilities have different treatment protocols, but you may be asked to spend time lying down and perhaps rolling on each side and front and back to ensure the chemical makes contact with the whole bladder lining.
Maintenance treatments of BCG may be prescribed to reduce the risk of the tumour recurring. This often involves a three-week treatment plan every three to six months for up to three years.
The initial treatments usually produce few if any side effects, but as the treatments progress, you may experience burning when urinating, a sense of urgency to urinate or the need to urinate more frequently. Some people report fatigue and a mild fever, achiness and nausea. There can be severe reactions, such as pain, inflammation and bleeding, but these are not the norm and diluted or reduced amounts of BCG can be given to help combat these side effects.
TREATMENT WITH MITOMYCIN C
The Mitomycin C treatment you may have had during your TURBT may be continued with a six-week course of treatment, much like the BCG schedule.
The side effects of Mitomycin C treatments are very similar to those experienced with BCG treatments.
ELECTROMOTIVE DRUG ADMINISTRATION (EMDA)
EMDA uses an electrical current to deliver BCG or Mitomycin C into the wall of the bladder. Clinical trials have shown that EMDA may get more of the drugs into the cells of the bladder wall, to further reduce the risk of the cancer coming back.
A small electrode is inserted into your bladder through a catheter. Your bladder must be empty and you will have an ultrasound scan to check. The doctor then washes out your bladder with sterile water and sticks two patches on to your skin, on the lower part of your abdomen. The patches also contain electrodes.
Your doctor attaches the wires from the electrodes to a small generator. The drug is inserted into your bladder through the catheter and the generator is turned on. A small electrical current passes through the patches. The electrical current draws the drug into the cells of the bladder lining. You may have a small tingling feeling but it isn’t painful. You have the treatment once a week for 6 weeks. Each treatment lasts for about 30 minutes.
Side effects can be similar to BCG and Mitomycin C treatments. You may also have irritation to skin where the electrodes were attached.
