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What Is BCG Bladder Cancer Treatment?

By Valerie Clark
Updated: Feb 21, 2024

A bacillus Calmette-Guerin (BCG) bladder cancer treatment is a form of immunotherapy that greatly reduces the risk of reoccurring tumor formation in the bladder after the cancer has been surgically removed. The treatment is ideal for patients who are at medium or high risk of reoccurring cancer. Historically developed as a vaccine for tuberculosis (TB), BCG is prepared from a live strain of a weakened bacterium, bovine tuberculosis bacillus, which has a stimulating effect of the immune system.

Since the 1980s, mounting evidence has shown the effectiveness of a BCG bladder cancer treatment as a viable form of immunotherapy. Although the exact mechanism is unclear, the BCG bacterium works by stimulating the immune system to fight cancer cells. A synthetic form of an immune system protein called interferon, which can help the body fight infections, can be used to treat bladder cancer and is sometimes used in combination with BCG.

The BCG bladder cancer treatment is administered intravesically through a urinary catheter. Treatment usually is administered cyclically, once weekly for six weeks and every three to six months thereafter for two years. Fluid intake should be limited for four hours prior to receiving a BCG bladder cancer treatment. During treatment, urination is prohibited for two hours, and some movement might be required to ensure that the entire bladder wall is coated. Following treatment, caffeine drinks should be avoided for two hours, and the genital area should be washed after every urination for six hours.

Potential side effects of a BCG bladder cancer treatment are generally mild. Burning or pain during urination is common. Changes in urination, fatigue, joint aches, fever, loss of appetite and nausea have also been reported. Less common but more severe side effects include hepatitis; abscess; and inflammation of lung tissue, prostate, testicles or skin. Other less common but more severe side effects include contraction of the bladder, obstruction of the ureters, allergic reaction, low white blood cell count or bloody urine. People who are in an immunosuppressive condition or who are pregnant should not be exposed to BCG.

Historically, the most common use of BCG is for tuberculosis immunization. The BCG vaccine was first used in humans in 1921. Health experts recommend the administration of BCG to children who are born in countries where TB is common. There are a handful of other uses for BCG, including treatment of leprosy, buruli cancer, colorectal cancer, diabetes, chronic inflammatory bladder problems and multiple sclerosis.

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