BCG Treatments for Bladder Cancer
BCG Treatments for Bladder Cancer
BCG (Bacillus Calmette Guerin) is a vaccine which is used to prevent tuberculosis (TB) in some countries. It has been found as a helpful treatment for bladder cancers when instilled directly into the bladder.
BCG is a type of immunotherapy in that it stimulates the body's immune system to destroy cancer cells.
How Is It Given?
BCG treatments are generally performed in an outpatient setting-- usually in the office. The treatment only takes a few minutes and you go home afterwards.
There are generally six treatments in a regimen, each given one week apart that start about a month after any surgery to remove tumors.
Since BCG is a bacteria, You won’t be given treatment with BCG if you are unwell, have an infection in your urine or visible blood.
We ask that you limit the amount you drink before your treatments. This will help to increase the concentration of BCG in your bladder.
Drinking too much before your treatment may make your bladder feel uncomfortably full. If you normally take water tablets (diuretics) take them later in the day after your treatment. Your nurse or doctor will give you more advice about preparing for your treatments.
You will have a small tube (catheter) placed into your bladder. Your doctor will then put the liquid vaccine directly into your bladder through the catheter and remove the catheter.
You will need to hold your urine for two hours afterwards. This can be difficult but it is to give the treatment time to work. You can walk around during this time. When the treatment is over you can go to the toilet.
After each treatment there are some precautions you’ll need to take. This is because BCG is a live vaccine and other people shouldn’t be exposed to it.
For the next six hours, you will need to avoid your urine splashing on the toilet seat and getting any urine on your hands. It might be easier for men to sit down when they are using an ordinary toilet although using a stand up urinal is OK. You will also be asked to put 1/2 cup undiluted bleach into the toilet bowl to destroy any live vaccine and leave it for 15 minutes until you flush.
Because BCG goes directly into the bladder most of the side effects are linked with the bladder. They usually go away within one to two days after your treatment. The most common ones are:
• Feeling the need to pass urine often
• Pain when you pass urine
• Blood in the urine
• Flu-like symptoms (tiredness, general body aches and a raised temperature)
These side effects should settle down within a day or two. If they don’t improve, contact the office. Drink plenty of fluids to help flush the drug out of your bladder and minimize the side effects. Unless contraindicated for another reason (diabetes, GERD, kidney problems), take ibuprofen (Motrin) or naproxen (Aleve) to help with symptoms.
Rare side effects can include a continuing high temperature (fever), pain in your joints and a cough. If you have any of these symptoms, or if you feel generally unwell, contact your doctor immediately. These symptoms could be a sign of a more serious infection (due to BCG) that needs to be treated immediately. If this happens you’ll be treated with the same drugs (antibiotics) that are used to treat TB.
Men should use a condom during sex for the first 48 hours after their treatment. If you are a woman who has had BCG treatment then your partner should use a condom. Using a condom will protect your partner from any vaccine present in your semen or vaginal fluid.
We don’t know how BCG may affect a developing fetus so it’s not advisable to become pregnant or father a child while having it. It is important to use effective contraception during your treatment and for six weeks afterwards. You can discuss this with your doctor or specialist nurse.
Adapted from Macmillan cancer support and the Oncology Nursing Society cancer chemotherapy guidelines.
Reviewed by: Clay Reeves, NP-C 6/10/2013
Approved by: SMMC Cancer Committee Date: 6/2/2010