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Urology (Expert Forum)
Possibility of recurrence; effects of BCG immunotheraphy
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Doctor's Answer
by hfhs M.D.-AK, Oct 12, 1999 12:00AM
Dear Richard,
Immunotherapy of the bladder for superficial bladder cancer is often performed with BCG. This is a widely distributed attenuated strain of M. bovis. Several strains have been investigated as intravesical immunotherapy. The drug causes inflammation of the bladder mucossa, and its therapeutic activity may be particularly attributable to this effect. Although the immunologic response is clearly involved, the exact mechanism is unknown.
At present, BCG is considered the treatment of choice for CIS. It has a complete response between 60 and 78% of the time. You will need some sort of surveillance protocol and if tolerated, a follow-up coarse beyond the usual 6 doses in six weeks has been shown to further reduce recurrence.
In regards to toxicity, 2,602 patients were studied by Dr. Lamm an expert in superficial bladder cancer. In his study more than 95% of the patients were able to tolerate the side effects and complete therapy. About 2.5% had fever, 1% had granulomatous prostatitis, and 1% had hematuria. You will probably experience some irritative voiding symptoms during therapy, but these should disappear over time. More serious side effects like sepsis and systemic infections can occur, but are less common.
Overall, BCG is the best we have for Cis of the bladder. It should not effect your ability to have an erection, however The thought of having a catheter placed for treatment and the knowledge that you have bladder cancer may be affecting your thought patters. Good Luck, I think you are on the right track. Make sure you follow-up with your scheduled cystoscopy (usually every 3-6 months).
The information provided in this forum is presented for general educational purposes only. Specific questions you have pertaining to your health should always be directed to your personal physician.
Sincerely,
HFHS M.D.-AK
*keyword: Bladder cancer
Immunotherapy of the bladder for superficial bladder cancer is often performed with BCG. This is a widely distributed attenuated strain of M. bovis. Several strains have been investigated as intravesical immunotherapy. The drug causes inflammation of the bladder mucossa, and its therapeutic activity may be particularly attributable to this effect. Although the immunologic response is clearly involved, the exact mechanism is unknown.
At present, BCG is considered the treatment of choice for CIS. It has a complete response between 60 and 78% of the time. You will need some sort of surveillance protocol and if tolerated, a follow-up coarse beyond the usual 6 doses in six weeks has been shown to further reduce recurrence.
In regards to toxicity, 2,602 patients were studied by Dr. Lamm an expert in superficial bladder cancer. In his study more than 95% of the patients were able to tolerate the side effects and complete therapy. About 2.5% had fever, 1% had granulomatous prostatitis, and 1% had hematuria. You will probably experience some irritative voiding symptoms during therapy, but these should disappear over time. More serious side effects like sepsis and systemic infections can occur, but are less common.
Overall, BCG is the best we have for Cis of the bladder. It should not effect your ability to have an erection, however The thought of having a catheter placed for treatment and the knowledge that you have bladder cancer may be affecting your thought patters. Good Luck, I think you are on the right track. Make sure you follow-up with your scheduled cystoscopy (usually every 3-6 months).
The information provided in this forum is presented for general educational purposes only. Specific questions you have pertaining to your health should always be directed to your personal physician.
Sincerely,
HFHS M.D.-AK
*keyword: Bladder cancer
