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.
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 happens if BCG 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%.
Is the second BCG treatment as effective as the first?
Results: Complete response after 6 months was marginally better in patients treated with 2 induction cycles of BCG than one (92% vs. 83%). Tumors recurred in 11% of patients receiving two BCG courses vs. 29% of patients treated with initial 6-week BCG induction (p = 0.03).
Why is a 2nd TURBT needed?
A second TURBT can detect residual cancer and provide accurate pathological information. A second TURBT procedure should be recommended in all cases with T1 high-grade bladder cancer to accomplish adequate tumor resection and to identify patients who may need to undergo prompt radical cystectomy.
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.
Can BCG treatment damage the bladder?
The most common complications associated with BCG treatment are relatively minor. They include urinary frequency, cystitis, fever, and hematuria. Although serious complications are rare, patients can develop severe, life-threatening sepsis with disseminated mycobacterial infection.
What are the long term side effects of BCG treatment?
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.
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).
Can high grade urothelial carcinoma be cured?
High-grade T1 (T1HG) bladder cancer (BCa) has a very high likelihood of disease recurrence and progression to muscle invasion. Radical cystectomy is considered the best chance at cure, albeit with a high risk of morbidity, and is overtreatment for some patients.