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Bacillus Calmette-Guerin (BCG) for Bladder Cancer

How It Works

Bacillus Calmette-Guerin (BCG) is used to treat bladder cancer because it stimulates immune responses that can destroy cancer cells within the bladder. BCG may be used to treat early-stage cancer, but it is used most commonly to prevent the return (recurrence) of noninvasive bladder cancer. It is most often used after cancer has been removed from the bladder using transurethral resection (TUR)surgery.

BCG is also used in some countries as a vaccine to provide protection againsttuberculosis (TB).

When it is used to treat bladder cancer, BCG is given through a urinary catheter(intravesically) into the bladder.

• Limit your fluid intake for 4 hours before the procedure, so you will be able to hold the medicine in your bladder during the treatment.


• BCG is given through a urinary catheter. You will be asked not to urinate for 2 hours and to change position every 15 to 20 minutes so the medicine washes the entire bladder wall.


• For 6 hours after treatment, wash your genital area after every urination to avoidskin irritation.


• Treatment is usually given once a week for 6 weeks. After this, you may be treated again every month for 6 to 12 months or every 3 to 6 months over the next 2 years.

Why It Is Used

BCG is used following TUR surgery for noninvasive bladder cancer in people who are at medium or high risk for recurrence of cancer. It can also be used following TUR surgery in people who cannot have a cystectomy procedure for bladder cancer. But its usefulness in these cases is limited.

How Well It Works

Studies show that treatment with BCG delays the recurrence of cancer, slows cancer growth, and possibly helps people with bladder cancer live longer.¹

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

• Usually the benefits of the medicine are more important than any minor side effects.


• Side effects may go away after you take the medicine for a while.


• If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call911or other emergency services right away if you have:

• Trouble breathing.


• Swelling of your face, lips, tongue, or throat.

Call your doctor right away if you have:

• Hives.


• Hepatitis or abscess.


• Inflammation of the lung tissue (pneumonitis).


• For men, inflammation and infection of the prostate, testicles, or epididymis.


• Contraction of the bladder or obstruction of the ureters.


• Allergic reaction to BCG or disseminated tuberculosis.

Common side effects of this medicine include:

• Burning or pain with urination, a sense of needing to urinate often, or urinating small amounts often.


• Fatigue, joint aches, skin rash, or fever of less than 101°F (38°C).


• Nausea, vomiting, or loss of appetite.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

If you have major side effects from BCG treatment, you may need treatment withantibiotics and corticosteroids.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

Do not use this medicine if you are pregnant or planning to get pregnant. If you need to use this medicine, talk to your doctor about how you can prevent pregnancy.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF) to help you understand this medication.

http://www.webmd.com/cancer/bladder-cancer/bacillus-calmette-guerin-bcg-for-bladder-cancer