Conclusions: Grade of tumor recurrence after intravesical BCG is an important predictor of bladder cancer progression to MIBC/MUC. However, patients who have low grade recurrences on BCG still may progress and hence should be carefully counselled on bladder sparing therapy. © 2018 by American Society of Clinical Oncology
Full Answer
Can bladder cancer come back after BCG treatment?
60% of patients do not have their bladder cancer come back after BCG treatment, but 40% of the time cancer comes back within two years. First, make sure you haven’t had any fluids for four hours before the treatment.
What happens at the end of bladder cancer treatment?
For some people with bladder cancer , treatment can remove or destroy the cancer. The end of treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer coming back. This is very common if you’ve had cancer.
Can bladder cancer recur?
Bladder cancer cells can recur in the bladder or they can recur in other parts of the body. Some people who are treated for bladder cancer never have a recurrence. Although recurrence is not uncommon among people who are treated for bladder cancer, in many cases the recurrence can be treated effectively.
What is the prognosis of stage 0A bladder cancer?
After treatment for any stage 0 cancer, close follow-up is needed, with cystoscopy about every 3 months for a least a couple of years to look for signs of the cancer coming back or new bladder tumors. The outlook for people with stage 0a (non-invasive papillary) bladder cancer is very good. These cancers can be cured with treatment.
Does low-grade bladder cancer come back?
Low-grade bladder cancers recur frequently, and recurrences require treatment with a procedure called transurethral resection for bladder tumor, or TURBT. Some patients experience multiple recurrences and, as a result, undergo repeated surgeries.
What are the chances of bladder cancer returning after BCG treatment?
“Initially, it's effective,” says medical oncologist Noah Hahn, M.D. However, adds urologist Max Kates, M.D., “while up to 35 percent of patients have long-term, sustained remissions with intravesical BCG, as many as 60 percent of patients will have a recurrence of cancer within two years.
Does BCG work for low-grade bladder cancer?
Bacillus Calmette-Guerin or BCG is the most common intravesical immunotherapy for treating early-stage bladder cancer.
How many times can you have BCG treatments for bladder cancer?
BCG is in a liquid solution that is put into the bladder with a catheter. The person then holds the solution in the bladder for two hours before urinating. The treatment is usually given once per week for six weeks, starting approximately two to three weeks after the last TURBT.
What are the signs that bladder cancer has returned?
Tell your doctor about any new symptoms, such as pain during urination, blood in the urine, frequent urination, an immediate need to urinate, and any other symptoms. These symptoms may be signs that the cancer has come back or signs of another medical condition.
When does bladder cancer usually recur?
Conclusions. Nearly three-fourths of patients diagnosed with high-risk bladder cancer will recur, progress, or die within ten years of their diagnosis.
Can BCG treatment be repeated?
In patients who develop a CIS recurrence after a single prior BCG failure, repeat BCG-based therapy should be administered. Repeat BCG monotherapy has demonstrated a 2-year disease-free rate of 30–42% in two small studies [2, 59].
How long does BCG immunotherapy last?
Ongoing BCG treatment Maintenance treatment can last for 1–3 years, but treatment sessions become much less frequent (e.g. one dose a month). Treatment schedules can vary so ask your doctor for further details and see BCG safety at home.
What is the recurrence rate of bladder cancer?
Recurrence rates for bladder cancer depend on the stage of the original tumor, with 5-year recurrence rates of approximately 65% in patients with non-invasive or in situ tumors and 73% in patients with slightly more advanced disease at first diagnosis.
How often does BCG fail?
Evidence synthesis: Overall, the failure rate in response to BCG is about 40-50%. Most guidelines recommend that patients failing BCG should be offered radical cystectomy (RC).
What are the long term effects of BCG treatment for bladder cancer?
Summary. Commonly reported side effects of bcg include: urinary tract infection, detrusor hyperreflexia of bladder, fever, hematuria, urinary frequency, urinary urgency, vomiting, chills, and malaise. Other side effects include: arthralgia. See below for a comprehensive list of adverse effects.
What does it mean when bladder cancer comes back?
Patients with recurrent bladder cancer have cancer that has returned following initial treatment with surgery, radiation, chemotherapy or immunotherapy. A variety of factors ultimately influence a patient's decision to receive treatment of cancer.
Treating Stage 0 Bladder Cancer
Stage 0 bladder cancer includes non-invasive papillary carcinoma (Ta) and flat non-invasive carcinoma (Tis). In either case, the cancer has not inv...
Treating Stage I Bladder Cancer
Stage I bladder cancers have grown into the connective tissue layer of the bladder wall but have not reached the muscle layer.Transurethral resecti...
Treating Stage II Bladder Cancer
These cancers have invaded the muscle layer of the bladder wall. Transurethral resection (TURBT) is typically the first treatment for these cancers...
Treating Stage III Bladder Cancer
These cancers have reached the outside of the bladder and might have grown into nearby tissues or organs.Transurethral resection (TURBT) is typical...
Treating Stage IV Bladder Cancer
These cancers have reached the abdominal or pelvic wall (T4b tumors) or have spread to nearby lymph nodes or distant parts of the body. Stage IV ca...
Treating Bladder Cancer That Progresses Or Recurs
If cancer continues to grow during treatment (progresses) or comes back (recurs), your treatment options will depend on where and how much the canc...
What to do after bladder cancer treatment?
After your treatment for bladder cancer has ended, your healthcare providers will monitor you regularly during check-ups (also called follow-ups) for signs and symptoms that your cancer may have recurred. 1,2 This might involve tests such as physical examinations, urine tests, blood tests, and/or imaging tests.
What are the treatments for bladder cancer?
Some treatment options that can be used for bladder cancer recurrence, either alone or in combination, include: Surgery. Chemotherapy. Radiation therapy. Immunotherapy.
How does bladder cancer work?
1-3 Bladder cancer can be treated in many different ways. The tumor can be removed with surgery, and treatments such as chemotherapy and radiation therapy can be used to help kill any remaining cancer cells and to keep new cancer cells from growing.
How to reduce anxiety about bladder cancer?
If you find yourself worrying about bladder cancer recurrence, stress-relieving activities such as exercise or meditation might help to reduce your anxiety.
Can bladder cancer recur?
However, people who have been treated for bladder cancer sometimes develop recurrent bladder cancer. This is the term for cancer that has recurred, which means that the bladder cancer cells have started to grow again after the bladder cancer has been treated. Bladder cancer cells can recur in the bladder or they can recur in other parts of the body.
Is it important to have a check up for bladder cancer?
It is very important to continue visiting your healthcare provider regularly as scheduled for check-ups, especially if you are receiving active surveillance. Treatment for bladder cancer recurrence tends to be more effective when the recurrence is detected as early as possible.
Can bladder cancer recur in other parts of the body?
Bladder cancer cells can recur in the bladder or they can recur in other parts of the body. Some people who are treated for bladder cancer never have a recurrence. Although recurrence is not uncommon among people who are treated for bladder cancer, in many cases the recurrence can be treated effectively. This is especially true for non-invasive ...
The Early-Stage Bladder Cancer Treatment
Jennifer Welsh is a Connecticut-based science writer and editor with over ten years of experience under her belt. She’s previously worked and written for WIRED Science, The Scientist, Discover Magazine, LiveScience, and Business Insider.
Who Can Use BCG?
BCG is a treatment for early-stage bladder cancer that has not yet invaded the muscle of the bladder wall. Called non-muscle invasive bladder cancers (NMIBCs) or in situ bladder cancers, these account for about half of all bladder cancers. 3
What to Expect During BCG Treatment
First, make sure you haven’t had any fluids for four hours before the treatment. Right before you go into the treatment room your doctor or nurse will have you empty your bladder. 2
How to Prepare
To prepare for the BCG treatment, your doctor will likely have you undergo surgery to remove any visible cancer in the bladder. The surgery is called transurethral resection of bladder tumor (TURBT) and is usually done about two weeks before BCG therapy.
When to See a Doctor
There are a few side effects that can be especially dangerous, so make sure to talk to your doctor if you notice that you: 2
Other Treatments for Bladder Cancer
For many early-stage bladder cancers, BCG is the best option for treatment. Other treatments for bladder cancer include:
Summary
BCG treatment is a form of immunotherapy for non-muscle invasive bladder cancer. It is administered into the bladder through a catheter. It then activates the body's immune system to attack the cancer cells.
Doing my research about BCG
This treatment along with other alternatives was explained to me by my urologist after two operations to remove tumors from the bladder. My medical team was confident that my cancer was contained within the bladder lining. So as a result of this feedback and doing my research on the effects of BCG I opted for this course of treatment.
I felt great after the first 4 treatments
At best after each treatment of BCG I felt a bit wobbly and maybe even a bit tired. I could never be sure however if this was in my mind or a reality. When you have cancer and a professional tells you that you may feel tired after treatment, you feel tired even if you're not.
Side effects after my 4th treatment
Two days before my fifth session of BCG I was working out at the gym and found after 45 minutes that my body temperature was struggling to warm up. The tips of my fingers were also losing circulation, so I decided to cut my session short and go home. What was to follow after walking through my front door was 48 hours of unbelievable pain.
Severe pain and a loss of appetite
My entire body literally shut down on me. I had major fever type symptoms, excruciating pain in all joints and a severe headache. I was unable to eat and just about managed to take on fluids over the two days.
I learned to take it easy during treatment
I've since finished my BCG treatment and I'm now awaiting a biopsy to establish how successful my treatment was. My hope is that I’m given the all clear and allowed to move on with my life with just the little inconvenience of having to get myself checked every three months.
What to do if you have bladder cancer?
If you have (or have had) bladder cancer, you probably want to know if there are things you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements. Unfortunately, it’s not yet clear if there are things you can do that will help.
What tests are done to see if bladder cancer is growing back?
Your follow-up plan might include urine tests, physical exams, imaging tests (like x-rays, MRI, or CT scans), and blood tests. These doctor visits and tests will be done less often as time goes by and no new cancers are found.
How often should you have a cystoscopy?
If your bladder hasn’t been removed, regular cystoscopy exams will also be done every 3 months for at least the first 2 years. If you have a urinary diversion, you will be checked for signs of infection and changes in the health of your kidneys. Urine tests, blood tests, and x-rays might be used to do this.
What happens if you have a radical cystectomy and a urostomy?
If you had a radical cystectomy and now have a urostomy, you might worry even about everyday activities at first. You might have to alter some of your daily (and nightly) routines because of changes in how you urinate. Other issues such as having sex might also cause concerns (see below).
Can bladder cancer affect your sex life?
Bladder cancer treatment can often affect your sex life. (See Bladder Cancer Surgery for more on this.) Learning to be comfortable with your body during and after bladder cancer treatment is a personal journey, one that's different for everyone. Information and support can help you cope with these changes over time.
Does bladder cancer go away?
For other people, bladder cancer might never go away completely or might come back in another part of the body. Some people may get regular treatment with chemotherapy , immunotherapy, or other treatments to try to keep the cancer in check. Learning to live with cancer that doesn't go away can be difficult and very stressful.
Can bladder cancer be removed?
Living as a Bladder Cancer Survivor. For some people with bladder cancer , treatment can remove or destroy the cancer. The end of treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer coming back. This is very common if you’ve had cancer.