What is biological therapy for bladder cancer?
Patients with early bladder cancer may be able to receive a biological therapy (immunotherapy) called Bacillus Calmette-Guerin (BCG). It uses a weakened bacterium strain to stimulate the body's natural defenses to attack the cancer. The BCG solution is inserted into the bladder through a catheter into the urethra.
What is a BCG treatment for bladder cancer?
Bacillus Calmette-Guerin or BCG is the most common intravesical immunotherapy for treating early-stage bladder cancer. It's used to help keep the cancer from growing and to help keep it from coming back. BCG is a germ that's related to the one that causes tuberculosis (TB), but it doesn't usually cause serious disease.
How is BCG treatment 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.
What can I expect after a BCG treatment?
You may not notice any reaction after the first few BCG treatments. After the third treatment, patients usually start to experience bladder irritation pain or burning during urination, joint pain, fatigue, and flu-like symptoms that can last a few days.
What is a bladder wash?
A bladder instillation, or wash, can assist in managing many different bladder problems. Sometimes referred to as a bladder wash or bath, a bladder instillation is a treatment involving a solution inserted into the bladder through a catheter and released after a short period of time.
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.
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).
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.
What happens if BCG treatments don't work?
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%.
Is BCG considered chemo?
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.
Does BCG cause hair loss?
Hair loss does not occur with BCG.
Does BCG treatment make you tired?
BCG immunotherapy can cause a number of side effects. It is common for people to experience flu-like symptoms, such as chills, fever, and fatigue, for 2–3 days following the treatment. Other common side effects include: a burning sensation or discomfort in the bladder.
What is the first treatment for bladder cancer?
Chemo (with or without radiation) is typically the first treatment when bladder cancer has spread to distant parts of the body (M1). After this treatment the cancer is rechecked. If it looks like it's gone, a boost of radiation to the bladder may be given or cystectomy might be done.
What is stage 0 bladder cancer?
Stage 0 bladder cancer includes non-invasive papillary carcinoma (Ta) and flat non-invasive carcinoma (Tis or carcinoma in situ). In either case, the cancer is only in the inner lining layer of the bladder. It has not invaded (spread deeper into) the bladder wall.
What is the treatment for T3 tumors?
An option for some patients with single, small tumors (some T3) might be treatment with a second (and more extensive) transurethral resection (TURBT) followed by a combination of chemo and radiation. If cancer is still found when cystoscopy is repeated, cystectomy might be needed.
What to do if you have cancer that hasn't been removed?
(Less often, close follow-up alone might be an option.) If all of the cancer wasn't removed, options are intravesical BCG or cystectomy (removal of part or all of the bladder).
How to get rid of stage IV cancer?
The tumor is then rechecked. If it appears to be gone, chemo with or without radiation or cystectomy are options.
How long after TA surgery can you get chemo?
For low-grade (slow-growing) non-invasive papillary (Ta) tumors, weekly intravesical chemotherapy may be started a few weeks after surgery. If the cancer comes back, the treatments can be repeated. Sometimes intravesical chemo is repeated over the next year to try to keep the cancer from coming back.
What is the treatment for cancer that recurs in distant parts of the body?
Cancers that recur in distant parts of the body can be harder to remove with surgery, so other treatments, such as chemotherapy, immunotherapy, targeted therapy, or radiation therapy , might be needed. For more on dealing with a recurrence, see Understanding Recurrence.
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.
How does radiation therapy help bladder cancer?
Radiation therapy. Radiation therapy uses beams of powerful energy, such as X-rays and protons, to destroy the cancer cells. Radiation therapy for bladder cancer usually is delivered from a machine that moves around your body, directing the energy beams to precise points.
How to get a follow up on bladder cancer?
Get a schedule of follow-up tests and go to each appointment. When you finish bladder cancer treatment, ask your doctor to create a personalized schedule of follow- up tests. Before each follow-up cystoscopy exam, expect to have some anxiety. You may fear that cancer has come back or worry about the uncomfortable exam.
How to diagnose bladder cancer?
Tests and procedures used to diagnose bladder cancer may include: Using a scope to examine the inside of your bladder (cystoscopy). To perform cystoscopy, your doctor inserts a small , narrow tube (cystoscope) through your urethra. The cystoscope has a lens that allows your doctor to see the inside of your urethra and bladder, ...
What is the procedure called when you remove a sample of tissue for testing?
Removing a sample of tissue for testing (biopsy). During cystoscopy, your doctor may pass a special tool through the scope and into your bladder to collect a cell sample (biopsy) for testing. This procedure is sometimes called transurethral resection of bladder tumor (TURBT). TURBT can also be used to treat bladder cancer.
What is a low grade bladder cancer?
Low-grade bladder cancer. This type of cancer has cells that are closer in appearance and organization to normal cells (well differentiated). A low-grade tumor usually grows more slowly and is less likely to invade the muscular wall of the bladder than is a high-grade tumor. High-grade bladder cancer.
What tests can be done to determine if you have bladder cancer?
Tests may include: CT scan.
How is bladder cancer classified?
Bladder cancers are further classified based on how the cancer cells appear when viewed through a microscope. This is known as the grade, and your doctor may describe bladder cancer as either low grade or high grade:
What is the procedure called to remove bladder cancer?
It usually follows a procedure called transurethral resection of bladder tumor (TURBT). It’s intended to help prevent recurrence. This treatment only affects cells inside the bladder. It’s not useful for later stage bladder cancer that has spread into or beyond the bladder lining, or to other tissues and organs.
How long does it take for a bladder catheter to unclamp?
You’ll be instructed to lie on your back and to roll from side to side to make sure the solution reaches your entire bladder. After about two hours, the catheter is unclamped so the fluid can be drained. If the catheter was already removed, you’ll be asked to empty your bladder at this time.
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 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.
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.
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 ...
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.
What are the best drugs for bladder cancer?
These drugs can be used in different situations to treat bladder cancer: 1 Any of these checkpoint inhibitors can be used in people with advanced bladder cancer that starts growing again after chemotherapy. 2 Atezolizumab and pembrolizumab can be used in people who can't get the chemo drug cisplatin (due to things like hearing loss, kidney failure, or heart failure). 3 Avelumab can be used as an additional (maintenance) treatment in people with advanced bladder cancer that did not get worse during their initial chemotherapy treatments. 4 Pembrolizumab can be used to treat certain bladder cancers that are not growing into the muscle wall of the bladder, are not getting smaller with intravesical BCG, and are not being treated with a cystectomy.
What antibody is used to attach to a bladder cancer cell?
In the case of this ADC, the monoclonal antibody part attaches to the Trop-2 protein on bladder cancer cells and brings the chemo directly to them. (Some bladder cancer cells have too much Trop-2, which helps them grow and spread.)
What drugs target PD-L1?
Atezolizumab (Tecentriq) and avelumab (Bavencio) are drugs that target PD-L1, a protein on cells (including some cancer cells) that helps keep the immune system from attacking them. By blocking PD-L1, these drugs boost the immune system's response against the cancer cells. This can shrink some tumors or slow their growth.
Can BCG be put in the bladder?
BCG can be put right into the bladder as a liquid. This activates immune system cells in the bladder, which then attack bladder cancer cells. For more details on this treatment, see Intravesical Therapy for Bladder Cancer.
Can PD-1 block bladder cancer?
Blocking PD-1 can allow the immune system to attack the cancer cells, which can shrink some tumors or slow their growth. These drugs can be used in different situations to treat bladder cancer: Any of these checkpoint inhibitors can be used in people with advanced bladder cancer that starts growing again after chemotherapy.
Does chemo kill bladder cancer?
The chemo enters the cancer cells and kills them. This drug may be used to treat people with advanced bladder cancer who have already been treated with a platinum chemo drug (such as cisplatin) and immunotherapy (specifically, a PD-1 or PD-L1 inhibitor). Enfortumab vedotin is infused into a vein (IV), once a week for 3 weeks with one week off.
