Questions posted in the The Urology Forum have been answered by urologists from Henry Ford Health System and by Dr. Kevin Pho.

Question Title: BCG treatment: side-effects

Forum: The Urology Forum
Topic: Bladder Cancer


Are there any side-effects associated with use of bcg vaccine as a treatment for bladder cancer? What is the current thinking regarding possible length of treatment with bcg?

Thank you.
VME



Dear Victoria,
Bladder irritability is the main side-effect of BCG. It can be relieved by oral medications to relax the bladder. The symptom complex involves dysuria (burning with urinating) 91%, urinary frequency 90%, hematuria (blood in the urine) 46%, fever 24%, malaise 18%, nausea 8%, chills 8%, arthralgia 2% and pruritis 1%. There is a small risk of the BCG getting into the blood stream and causing systemic infection (called BCGosis). This requires antituberculous therapy in about 6% of patients. There have been a few deaths on this basis.
The current length of therapy recommended by SWOG (Southwest Oncology Group), is 6 weeks of induction therapy followed by 3 weekly installations at 3 months, 6 months, and then every six months for three years. This regimen has shown a significant decrease in recurrence when compared to just six weeks of therapy (old standard).
The important thing is that you get some type of regimen from your doctor. BCG is the most effective therapy to prevent recurrence and treat carcinoma in situ of the bladder. It is not well tolerated by everyone and what ever dosing schedule that is eventually be decided upon is a good start.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).

Sincerely,
HFHS M.D.-AK
*keyword:Bladder Cancer, BCG





 

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