BCG to Treat Bladder Cancer
BCG, which stands for Bacillus Calmette-Gurin, is a type of immunotherapy used to treat bladder cancer. It is a live attenuated strain of Mycobacterium bovis, which is a bacterium similar to the one that causes tuberculosis (TB). However, BCG itself does not tend to cause serious illness.
BCG is primarily used as a vaccine against tuberculosis, but it has also been found to be effective in treating non-muscle invasive bladder cancer (NMIBC). NMIBC refers to bladder cancer that has not spread to the muscles of the bladder or other parts of the body.
The use of BCG in treating NMIBC has been studied for several decades, and it has shown promising results. BCG therapy helps reduce the risk of tumor recurrence and decreases the likelihood of the cancer progressing to a more invasive stage.
The exact mechanism of how BCG works in treating bladder cancer is still being studied, but it is believed to activate both the immune system. This activation eventually leads to the destruction of tumor cells in the bladder.
BCG therapy for bladder cancer involves delivering the drug directly to the bladder using a catheter. The healthcare professional will administer BCG into the bladder as a liquid drug. This method allows the drug to come into direct contact with the cancer cells in the bladder, targeting them specifically and not affecting other parts of the body.
It's important to note that BCG therapy is most effective in the early stages of bladder cancer, before it has spread to other parts of the body. It is typically recommended for people with high-risk NMIBC, such as those with carcinoma in situ.
While BCG therapy is generally safe and well-tolerated, there are some potential side effects. Some people may experience flu-like symptoms for a few days after receiving BCG therapy. In rare cases, BCG can spread to other parts of the body and cause an infection. If anyone experiences signs of infection or serious side effects, it's important to speak with their doctor immediately.
BCG, or Bacillus Calmette-Gurin, is a type of treatment used for bladder cancer. It is a bacterium that is similar to the one that causes tuberculosis (TB), but it does not cause serious illness. BCG therapy works by stimulating the immune system to attack and destroy cancer cells in the bladder.
Here's how BCG therapy works:
- Infection of bladder cells: When BCG is administered into the bladder, it infects the bladder epithelial cells and/or cancer cells. This infection stimulates the local immune response by activating certain cells in the immune system, such as granulocytes, macrophages, and T helper cells.
- Immune response activation: The infection caused by BCG leads to an increased secretion of these immune cells, which helps in fighting against the cancer cells in the bladder. This immune response is responsible for the anti-tumor effect of BCG therapy.
- Reduction of recurrence and progression: BCG therapy has been shown to reduce the risk of both recurrence and progression of bladder cancer. It is considered the standard of care for high-risk tumors.
- Side effects and irritation: While BCG therapy can be effective, it can also cause side effects and irritation. The administration of cytotoxic drugs (drugs that kill cancer cells) can have many side effects. Immunotherapy (such as BCG therapy) may lead to local irritation of the bladder epithelium that can cause frequency or burning with urination or blood in the urine.
- Recurrence and repeated procedures: Recurrences of bladder cancer are common even after BCG therapy. This often requires repeated resection procedures (removal of cancerous tissue). Therefore, researchers are looking for new supportive care options to inhibit or reduce cancer recurrence after transurethral resection (a surgical procedure used to remove tumors from the bladder).
BCG therapy is administered by the healthcare professional in the office or clinic. The doctor will provide instructions for self-care during BCG treatment. Information and instructions may include:
- During the treatment, a healthcare professional will administer BCG into the person's bladder in the form of a liquid drug. A catheter is inserted through the urethra into the bladder to allow the drug to come into direct contact with the cancer cells in the bladder, targeting them specifically.
- After receiving BCG therapy, it is important for the person to hold their urine for 2 hours before emptying their bladder.
- Precautions need to be taken when urinating for several hours following the treatment to prevent passing the live bacteria in BCG to other people.
- Precautions include drinking plenty of liquids, sitting instead of standing when urinating, adding undiluted bleach and waiting 15 minutes before flushing, and thoroughly washing hands and genitals after urinating.
- For individuals receiving weekly BCG treatments, it is recommended to use a condom during sex.
- Women undergoing BCG immunotherapy should avoid becoming pregnant or breastfeeding until the treatment has ended.
Potential side effects and precautions related to BCG therapy:
- Common side effects of BCG include irritative urinary symptoms like dysuria (painful urination), urinary frequency (urinating more often), and urinary urgency (feeling the need to urinate urgently). These symptoms are usually temporary.
- Flu-like symptoms such as chills, fever, and fatigue are also common for a few days after having BCG therapy.
- Serious side effects from BCG therapy are rare but can occur. If you experience signs of infection or serious side effects, it is important to speak to your doctor immediately.
- In rare cases, BCG can spread outside of the bladder and cause an infection. Symptoms of this can include shortness of breath, dizziness, fever that does not respond to medications, confusion, joint pain, fatigue, and a skin rash.
- Additional complications can occur if the infection spreads further. These complications may include hepatitis (a liver infection), inflammation of the lungs, or inflammation of the testes or prostate.
It's important to remember that while these potential side effects exist, they are generally rare. If you have any concerns or questions about using or taking BCG therapy, it's always best to talk with your doctor. They can provide personalized advice based on your specific situation.