Don't be afraid of BCG treatment - let's talk about it

When your doctor tells you or someone in your family has bladder cancer, they may also mention BCG treatment. Hearing this name may make you feel a little scared and unfamiliar. But don't worry. This is a very successful treatment for many people with early-stage bladder cancer. Today, we'll talk about what BCG treatment is, how it's done, and what happens after it in a very simple, understandable way.

What is BCG treatment in simple terms?

Okay, the first thing to say is, this is not a cancer treatment, it's not ' chemotherapy '. This is something different. We call it 'immunotherapy'.

Simply put, this uses your own immune system to destroy cancer cells in the bladder. Imagine that the guards in our bodies are a little sleepy. This medicine wakes up those guards and tells them, "There's an enemy here, go and attack."

This liquid medicine called BCG is made from the same bacteria `(Mycobacterium bovis)` that is used to make the vaccine for tuberculosis . But don't worry, this contains a much weakened version of that bacteria. So it won't cause much harm to the body.

This treatment usually begins after the cancerous tumors in the bladder are removed surgically. We also call this surgery `(TURBT)`.

What conditions is this treatment used for?

BCG treatment is mainly used for early-stage bladder cancer . That is, when the cancer has not yet spread to the muscles of the bladder wall. Doctors call these conditions `(carcinoma in situ)` or `(non-muscle invasive bladder cancers - NMIBCs)`.

Research is currently underway to see if BCG treatment will be beneficial for diseases such as fibromyalgia and diabetes, but no firm conclusions have been reached yet.

How should I prepare before treatment?

This is very simple. Your doctor will give you clear instructions about this. Usually, you will be asked to stop drinking caffeinated drinks like coffee and tea and diuretics 4 hours before your treatment. Also, when you arrive at the hospital, you will need to urinate and empty your bladder before the treatment begins.

What happens during treatment?

There's nothing to worry about, this is a very simple process.

1. First, you will be given a medicine to numb the area so that you don't feel any discomfort.

2. Then, the doctor will very carefully insert a small tube ( catheter ) into your urethra and inject the BCG medication into your bladder.

3. Once that's done, the tube will be removed. You can go home.

But there is one thing. This medicine needs to be kept in the bladder for at least 2 hours . Therefore, you should not urinate for 2 hours after applying the medicine. After 2 hours, you can urinate normally.

Can this be transmitted to others? - Be especially careful with this!

This is very important. Yes , because this medicine contains live, weakened bacteria, it can have some effect on other people if it comes into contact with them. Therefore, you must do the following within the first 6 hours after each treatment :

• Do not use public toilets.
• Drink plenty of water and fluids to dilute your urine.
• When going to the toilet, urinate while sitting to prevent urine from spilling out.
• After you're done urinating, pour about 2 cups of bleaching powder or liquid into the toilet bowl, close the lid, leave it for 15-20 minutes, and then flush.
• If you have urinary incontinence and it gets on your clothes, wash those clothes separately in the washing machine. Do not put them together with other people's clothes.
• If you use an incontinence pad, before removing it, add a little bleach to it, soak it, place it in a plastic bag, seal it, and throw it in the trash.

Also, you should be careful about having sex. If you have sex during the entire treatment period , it is mandatory to use a condom. Talk to your doctor about this and get specific advice.

What are the benefits and side effects of the treatment?

Like any treatment, it has its benefits and minor side effects. Let's talk about the benefits first. BCG treatment with ``TURBT`` surgery is considered a very effective treatment for early-stage bladder cancer. It controls the growth of cancer cells and reduces the risk of having to undergo a ``cystectomy`` surgery to remove the entire bladder in the future.

Now let's look at the side effects. Most of these occur within the first 2-3 days after treatment and go away.

When should I see a doctor immediately?

Although a mild fever and body aches are common, if you experience any of the symptoms below, you should call your doctor without delay . Or go to the Emergency Department (ETU) of the nearest hospital.

• If the fever is higher than 38.5 Celsius (101.3 Fahrenheit).
• If you feel cold and shivering.
• If you are shivering severely.
• If you are experiencing severe pain due to bladder spasms.

Can cancer come back after treatment?

As with any cancer treatment, there is a risk that the cancer will come back. Statistics show that about 40% of people who receive BCG treatment will have their cancer come back. But there is something important to understand here. Even if the cancer does come back, it is usually not as aggressive.

Most often, low-grade cancer comes back. However, in rare cases, if the cancer is aggressive, your doctor may recommend a cystectomy to remove the bladder.

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