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Intravesical BCG Therapy: A Guide for Bladder Cancer Patients
By Raveena M Prakash
Bladder cancer is one of the most common cancers affecting the urinary system, it often requires treatments like targeted treatments for effective disease and treatment management. One of the most used therapies for non-muscle invasive bladder cancer (NMIBC) is intravesical Bacillus Calmette-Guerin (BCG) therapy. This is an effective cancer treatment, often intimidating to patients at first, and is a powerful tool in managing bladder cancer and preventing the risk of cancer recurrence.
In this blog, we’ll discover more about intravesical BCG therapy and how it works, and what the patients can expect during the treatment process.
What is Intravesical BCG Therapy?
Intravesical BCG therapy generally uses Bacillus Calmette-Guerin, commonly referred to as BCG therapy, a weakened strain of the tuberculosis bacterium. This helps to stimulate the immune system and attack the superficial bladder cancer cells directly inside the bladder. This is often delivered through a catheter, this is the most effective treatment for many early-stage bladder cancers, usually reducing the risk of recurrence and progression.
It is highly effective in treating high risk NMIBC of bladder tumours, which is often limited to the inner lining of the bladder. For patients who had high-risk non-muscle-invasive tumors, BCG therapy can reduce the risk of these tumors returning or progressing into more invasive forms of cancer.
Factors depending on the success rate of BCG Therapy
The success rate of these therapies generally varies depending on several factors, including the grade and stage of the cancer, along with a healthy individual response to treatment. In general, some patients might achieve long-term remission, while others will experience recurrence or progression, which further requires an alternative therapy.
How effective is BCG Therapy for Bladder cancer
BCG therapy is considered highly effective against non-muscle invasive bladder cancer (NMIBC), with remission rates around 70%, and is often considered the most effective non-surgical treatment for NMIBC. These treatments work by stimulating the immune system to target and destroy cancer cells within the bladder. While successful for many, it doesn’t work or isn’t suitable for everyone, with failure rates around 40%.
What to expect during the treatment?
Intravesical BCG therapy typically involves a series of other treatments. Many patients usually receive one dose of BCG per week for 6 weeks in the initial treatment plan, with the procedure often repeated constantly in subsequent years. After the initial 6-week course, maintenance therapy might be recommended. Usually with the doses every 3 to 6 months for a few years. While the specific schedule mainly depends on the patient’s response and the doctor’s recommendation.
Here’s what you can expect during the procedure, including:
- These treatments are delivered in a hospital or outpatient clinic
- A catheter is inserted through the urethra into the bladder
- The BCG solution is instilled into the bladder through the catheter
- Cancer patients are instructed to hold the solution in the bladder for about 2 hours
- This might cause mild discomfort or urgency
- Holding the solution allows a maximum contact with the bladder lining for its best effectiveness
- After completing 2 hours, the patient can empty their bladder.
Post-Treatment Care and Follow-up
After completing the procedure, regular follow-up appointments are essential to monitor the effectiveness of treatment and check for signs of cancer recurrence. It usually involves cystoscopy, a procedure in which a thin tube with a camera is inserted into the bladder to look for any remaining or new tumors. Urine cytology may also be used to check for cancer cells.
Patients are generally advised to stay hydrated, which helps to flush out any remaining BCG from the bladder and to avoid urinary tract infections. It also recommended avoiding any kind of rigorous physical activity for a short time after the procedure to minimize discomfort and reduce the risk of complications.
Side effects of Intravesical BCG Treatment
Like any other cancer treatments, BCG treatment can have side effects and complications, although most of the side effects are temporary and generally manageable.
Here are common side effects of Intravesical BCG Treatments, including:
- Bladder Irritation: Some bladder cancer patients might experience an increased urgency, frequency, or discomfort while urinating. This is considered one of the common side effects of these treatments.
- Hematuria (Blood in urine): Some patients might experience small amounts of urine in their blood, which can be highly alarming but usually disappear after the cancer treatments.
- Flu-like symptoms: There are symptoms like fever, chills, fatigue, and muscle pain that can occur when you are undergoing these treatments. Some of these symptoms are temporary; this will get better after some time.
- Urinary tract infections (UTIs): In some cases, this BCG therapy will increase the risk of developing urinary tract infections. It's essential to drink more water and stay hydrated during the treatment and additionally report the symptoms of infection, like burning or cloudy-colored urine.
Is BCG treatment contagious to other people?
Yes, these treatments are contagious to other people. The drugs used for this treatment generally contain live bacteria, which can be infected to other people. To reduce the risk of bacterial contamination, follow this advice for 6 hours after every BCG procedure.
Here are some instructions each bladder cancer patients might follow, including:
- Do not use public toilets
- Drink a lots of water and stay hydrated
- Try to sit down the toilets and avoid splashing
- After the urination, try to add 2 cups of undiluted bleach to the toilet, then close the lid, wait for 20 to 30 minutes and then flush the toilet.
- If you are someone who has urinary incontinence (loss of bladder control), then immediately wash your clothes in a washing machine.
- Don’t wash your clothes with others
- If you wear an incontinence pad, pour bleach on the pad, allow it to soak in, then place it in a plastic bag and discard in the trash.
Consult Today
Intravesical BCG therapy is a significant treatment for non-muscle invasive bladder cancer. While the procedure might seem intimidating at first for each bladder cancer patient. These treatments are highly effective and well-established treatments that can highly reduce the risk of recurrence of bladder cancer. It helps to stimulate the body’s immune system to fight against cancer cells. These treatments offer hope for many patients in managing their disease long-term.
At Oncare, we offer premium-quality cancer treatments, including advanced cancer surgeries at affordable price ranges with an experienced cancer specialist consultation.
If you or any loved ones of yours are diagnosed with cancer, then visit Oncare Cancer Center and book an appointment with our experienced cancer specialist. Get an estimated cost of your cancer treatment today!
Frequently Asked Questions
Like any other cancers, bladder cancers can also potentially return after the treatment. The cancer often recurs in up to 40% of people who receive BCG treatment. It's important to note, however, that even if the cancer returns, it may not progress.
The BCG treatment is currently considered the most common intravesical immunotherapy to fight early-stage bladder cancer.
Here are some of the side effects of BCG treatments, including:
- A small amount of blood in the urine
- Low grade fever
- Tiredness
- Burning sensation while urinating
- Frequent urination
- Muscle pain
- Joint pain
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