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BCG immunotherapy for bladder cancer.


BCG or Bacillus Calmette-Guerin is an FDA approved immunotherapy used to treat some forms of non-muscle invasive bladder cancer. For nearly four decades, BCG immunotherapy has been an established treatment option designed to stimulate a patient’s immune system to attack and destroy bladder cancer cells.

Immunotherapy treatment

Typically, this treatment option is performed as an in-office procedure in which BCG is instilled directly into the bladder. This procedure is accomplished by placing a catheter through the urethra into the bladder. The bladder is drained, so that the there is not over dilution of the treatment. The solution is then infused into the bladder through that catheter. Once the medication has been delivered, the catheter is removed. At this point, the patient aims to hold the solution within the bladder for about two hours. Patients initially being treated with immunotherapy for bladder cancer, should expect to be treated once per week for six weeks.

When BCG is placed inside the bladder, it is coming in direct contact with the bladder lining. It is not penetrating deep into the bladder walls, where late-stage cancer may have spread. Therefore, it is not an effective treatment option for late-stage bladder cancer.

Preparing for BCG treatment

Before proceeding with treatment, the provider will discuss the steps of this procedure with the patient, as well as common side effects, and expected outcomes. They will also review the patient’s current medications and any specific health conditions.

There is very little preparation needed prior to this treatment option. The primary requirement is to make sure that the bladder is empty before proceeding. This allows the patient to comfortably hold the solution, and also prevents the solution from being diluted with urine.  A urine analysis will be performed to make sure that there are no signs of excess blood in the urine or that there is an infection of the urinary tract, both which would preclude treatment on that particular date.

Immunotherapy side effects

As with any medication, there is a risk of potential side effects. If the patient experiences unusual, long-term, or uncomfortable side effects, they should notify their provider. Following treatment, patients may experience:

  • Irritation inside the bladder.
  • Urinary urgency, frequency, or leakage.
  • Blood in the urine.
  • Low grade fevers or chills.
  • Bladder pain or pain with urination.
  • Fatigue.
  • Urinary Tract Infection.
  • MORE SERIOUS SIDE EFFECTS can be BCG sepsis, or a disseminated infection from the treatment.

If you have been recently diagnosed with early-stage (Stage 0 or 1) bladder cancer, and would like to learn more about BCG immunotherapy, contact Urology Austin to schedule a consultation with one of our physicians.