Intravesical route (Powder for Suspension; Powder for Solution) Bacillus of Calmette and Guérin (BCG) infections have been reported in health care workers and in patients because of exposure to the vaccine during preparation and administration. Serious and fatal disseminated BCG infections have occurred with intravesical administration.
Full Answer
What are the risks of BCG?
Because BCG does involve active bacteria, it can sometimes cause problems if the bacteria spread in the body. Although it is uncommon, such infections have occasionally occurred in multiple body systems, including the lungs, liver, kidney, prostate, bone, and parts of the urinary system. Specific symptoms vary based on the organ involved.
What happens after a BCG treatment?
The fluid drains away, and someone removes the catheter. Because BCG therapy includes an active, live bacteria, you’ll need to take certain precautions. For about six hours after the treatment, you should urinate while seated (to avoid urine splashing). During this time, you should also add bleach to the toilet for 15 minutes before flushing.
What is the prognosis of toxic reactions to BCG?
Overall, toxic reactions were mild and self limited, and toxicity often could be easily managed by a reduction in the BCG dose (17 patients), temporary interruption of treatment (five patients), or cessation (four patients).
What type of drug is BCG?
Drug Type: BCG (Bacillus Calmette-Guerin) is an anticancer biologic response modifier. (For more detail, see "How this drug works" section below). Note: If a drug has been approved for one use, physicians sometimes elect to use this same drug for other problems if they believe it might be helpful.
Is BCG dangerous to others?
Some people may experience flu-like symptoms for a few days after having BCG therapy. In rare cases, BCG can spread to other parts of the body and cause an infection. Anyone who experiences signs of infection or serious side effects should speak to their doctor immediately.
How toxic is BCG?
BCG has a cumulative effect, so increased toxicity is to be expected during long-term administration. BCG toxicity is primarily a response of the cell-mediated immune system, and transient local or systemic infection appears to be important.
Is BCG treatment safe?
A recent study was published evaluating maintenance BCG therapy [23]. The authors observed a three-year recurrence free survival of 75.3% and disease-free survival of 96.1%. However, they reported a high complication rate of 81.5%.
How long are you contagious after BCG treatment?
Reproductive Concerns. Men having this treatment can pass on BCG during sex. To protect your partner from coming into contact with BCG, you should not have sex for 48 hours after each treatment. Use a condom if you have sex at other times during the treatment course and for six weeks after treatment has ended.
Do BCG side effects get worse with each treatment?
The irritative reactions usually are seen following the third instillation and tend to increase in severity after each administration. There is no evidence that dose reduction or antituberculous drug therapy can prevent or lessen the irritative symptoms of TheraCys.
What are long term side effects of BCG?
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.
What is the success rate of BCG treatment?
This method of treatment is considered a form of immunotherapy, which is an emerging form of cancer treatment. The success rate for BCG treatment for bladder cancer is about 90%, which is considered the best life-saving rate by any treatment.
Why is BCG so hard to get?
Although Merck has boosted its production of BCG by more than 100 percent and is producing the drug to the fullest extent of their manufacturing capacity, they are not able to sustain the increasing global demand of this product. This has led to supply constraints and a BCG shortage.
What happens if BCG treatment fails?
BCG failure usually carries a risk of recurrence but rarely of progression. For low-grade failure, intravesical chemotherapy is a valid option. This scenario is different from that where BCG intravesical therapy is unsuccessful in high-risk T1 disease and/or CIS, where a risk of progression may sometimes reach 50%.
How do you prepare for BCG treatment?
In general, patients are usually told to limit their fluid intake for 6 hours before treatment. Drinking less will ensure that less urine is produced, and this will prevent the BCG treatment from being diluted in the bladder.
Is BCG considered chemotherapy?
Is BCG treatment a form of chemotherapy? No. Although intravesical immunotherapy and intravesical chemotherapy are given the same way, these two treatments use different types of drugs. While chemotherapy drugs attack cancer cells directly, immunotherapy drugs harness the power of your immune system.
Is BCG better than chemo?
BCG is most commonly used in intravesical immunotherapy for NMIBC and appears to be more effective than intravesical chemotherapy in preventing tumor recurrence and progression. Especially for those with high-risk NMIBC, BCG immunotherapy is considered as a gold-standard treatment (29).
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.
What to do if you have a BCG infection?
Treating Complications of BCG Therapy. If you do experience a problem from BCG infection, you may need to receive targeted antibiotics , such as isoniazid and rifampin. 8 . Complications of BCG therapy sometimes don’t occur until years later.
How does a BCG catheter work?
The urinary catheter is inserted through the urethra (the tube carrying urine to the outside of the body). The solution containing the BCG is injected into the catheter. The catheter is clamped to help the BCG remain inside the bladder, where it can start to work.
How long does it take for a BCG catheter to unclamp?
You may be asked to roll around a bit to help the medication reach all parts of the bladder. After a couple of hours or so, the catheter is unclamped. The fluid drains away, and someone removes the catheter.
In 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.
For the Consumer
Bacillus of Calmette and Guérin (BCG) infections have been reported in health care workers and in patients because of exposure to the vaccine during preparation and administration. Serious and fatal disseminated BCG infections have occurred with intravesical administration.
For Healthcare Professionals
Applies to bcg: intravesical powder for reconstitution, percutaneous powder for injection
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
How to get rid of BCG in men?
Disinfect the urine by adding 2 cups of bleach into the toilet. Let it stand for about 20 minutes before flushing. You should also wash your genital area very carefully after you urinate, so your skin doesn’t become irritated from the BCG. Wash your hands thoroughly, too. Men can pass BCG to their partner during sex.
What to do before BCG?
Tell your doctor about all the medications you take. Certain immunosuppressants, antimicrobial therapies, and radiation therapies can interfere with BCG treatment. You’ll be advised to limit your fluid intake for four hours prior to ...
How does a BCG catheter work?
A urinary catheter is inserted through your urethra and into your bladder. Then the BCG solution is injected into the catheter. The catheter is clamped off so the solution stays in your bladder. Some doctors may remove the catheter at this time. You have to hold the medicine in your bladder.
How long after BCG treatment can you have sex?
Men can pass BCG to their partner during sex. For that reason, you should avoid sex for 48 hours after each treatment. Use a condom between treatments and for six weeks following your final treatment. Women should avoid getting pregnant or breastfeeding while on BCG therapy.
Can you have more than one cancer treatment?
how well you tolerate certain treatments. Cancer treatment usually involves more than one type of therapy, which can be given at the same time or one at a time. That makes it difficult to compare one treatment to another.
How BCG Is Given
BCG is given by intravesicular infusion. This means it is given directly into the bladder through a urinary catheter. The urinary catheter is inserted through the urethra (the tube which carries urine from the bladder to the outside of the body). The BCG solution is injected into the catheter, which is then clamped.
Precautions
Before starting BCG treatments, make sure you tell your doctor about any other medications you are taking (including over-the-counter drugs, vitamins, or herbal remedies).
Self-Care Tips
Limit fluid intake for 6-10 hrs before treatment and for 2 hours following installation of BCG, afterward resume normal fluid intake.
Monitoring and Testing While Taking BCG
You will be monitored regularly by your doctor while you are receiving treatment with BCG. Your doctor will order blood tests and other tests as needed to monitor side effects and check your response to therapy.
How BCG Works
Bacillus Calmette-Guerin (BCG) is an inactivated form of the tuberculosis bacteria. It works against cancer as a biologic response modifier. Biological response modifiers are substances that have no direct antitumor effect but are able to trigger the immune system to indirectly affect tumors.
aftereffects of BCG bladder treatment
Just trying to see if anyone else has had the same experience. Recently finished my second 'maintenance' treatment after being passed 'clear' following the main 6 treatments. So really good news but the aftereffects (if thats what they are?) seem to be lasting much longer than previously.
aftereffects of BCG bladder treatment
hello Dave, so you have , completed 9 BCG treatments, yes i would agree , the side effects do increase, i have just completed my twelvth . I found that the first 6 were ok ish but ,were feeling just a little more aggresive by number 6.
aftereffects of BCG bladder treatment
Hi James Thanks for that. l am beginning to realise that l may be getting off quite lightly having spoken to my BCG team. Things have improved a bit and l am hoping that l may have only one more maintenance treatment to come. You are absolutely correct about diet and keeping reasonably fit it really does help.
aftereffects of BCG bladder treatment
I have just seen this as had not visited Cancer Research previously & found the comments & experiences of great interest.
aftereffects of BCG bladder treatment
Hi. My first post. I have just had my cystoscopy following my 12th BCG treatment. I agree with others that the first 6 are a breeze, the second 3 more painfull, and the last 3 very painfull and drawn out. I asked for an extra weeks break between 11 and 12 to recover.
aftereffects of BCG bladder treatment
Hello dickie - I just had my 10th dose of BCG 4 days ago & no problems so far re. side effects. That is quite a relief after the last time, but as I have 2 more doses to go I will wait & see with fingers crossed. Apparently, according to my consultant & keyworker these effects vary greatly from person to person & also in severity.
aftereffects of BCG bladder treatment
Nice to hear you guys are going strong , I have not posted for a while.
Answers
Obviously the doctor who gave the treatments should have explained these things to you. Here is info on it https://www.drugs.com/sfx/bcg-side-effects.html. BCG is a live bacteria, that is why you pour bleach into the toilet, and why you can't have sex. He can transmit the bacteria into you through his urethra (the tube from his bladder).
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History of BCG
Uses
Before Getting BCG
- Before you start BCG, you’ll need to talk with your healthcare provider to make sure BCG is the best treatment for your NMIBC. You might have other options, like not doing BCG or picking a type of chemotherapy to be inserted into the bladder instead.4 BCG therapy usually follows a procedure called transurethral resection of bladder tumor (TURBT). This treatment removes all v…
Precautions and Contraindications
- BCG should not be used in people who are immunocompromised, such as from medical conditions like AIDS or from genetic medical conditions. People taking medications that can suppress their immune system (like corticosteroids or cancer therapies) should also not take BCG.6 People who are pregnant should not take BCG therapy if possible. Pregnancy should b…
How BCG Therapy Is Done
- BCG as an immunotherapy for cancer is given through a catheter into the bladder, never intravenously or as an injection. This is usually done in an outpatient setting. The professionals there will assemble the BCG so that it can be safely administered. Your clinician will give you specific instructions about how you need to prepare ahead of time. You may need to limit your fl…
Side Effects
- It’s not uncommon for people to experience temporary symptoms after BCG therapy. Some of these might include 1. Burning with urination 2. Increased urinary frequency 3. Small amounts of blood in the urine 4. Fever and chills 5. Fatigue8 Such symptoms usually only last a day or two. Severe complications from BCG are uncommon, but they do sometimes ...