Has the doctor told you or someone close to you that you have bladder cancer? And did he tell you that you need to have BCG treatment? You might be a little scared when you hear this name. You probably have a lot of questions about what BCG is, what it does, and whether there are any side effects. Don't worry, we'll talk about all this simply and clearly.
What exactly is BCG treatment?
Simply put, BCG is a major immunotherapy used to treat early-stage bladder cancer. 'Immunotherapy' is a treatment that stimulates, or "awakens," your body's own immune system to fight cancer.
This is a type of treatment called intravesical therapy . This means that the medicine is not given as a liquid by mouth or as an injection. Instead, it is injected directly into your bladder using a thin tube called a catheter.
BCG is a live, weakened form of bacteria. It is made from the same bacteria that are used to make the tuberculosis vaccine. When this bacteria enters the bladder, it activates the immune cells there and directs them to attack the cancer cells. Imagine, it is like using our own body's own defenses (immune cells) to fight cancer.
One of the great advantages of this treatment is that it directly targets only the cancer cells in the bladder. It doesn't have much effect on other parts of the body.
BCG treatment usually begins after a surgery called TURBT (Transurethral Resection of Bladder Tumor) . This surgery removes visible cancerous tumors in the bladder. BCG treatment is then used to destroy any remaining cancer cells.
What are the side effects of BCG treatment?
As with any treatment, BCG can have some side effects. However, most of these are temporary and manageable. These can be expected within the first 24 hours after treatment.
| Side effect | Description |
|---|---|
| Fever and body aches | It can make you feel cold, like you have a cold, and your muscles and joints may ache. You may also have a slight fever of 99-100 Fahrenheit. |
| Urinary tract inflammation and frequent urination | It is normal to feel burning, pain, and the need to urinate frequently when urinating. |
| A little blood in the urine | You may see a few small drops of pink blood in your urine. This is usually nothing to worry about. |
| Tiredness | The body may feel a little tired. |
| A situation that requires urgent attention! | |
| BCG Sepsis | This is a very rare, but very dangerous condition. It can be caused by the body's overreaction to an infection. If your fever is higher than 101.3 Fahrenheit (38.5 Celsius), call your doctor immediately or go to the nearest hospital's emergency department (ETU). |
In fact, sometimes these minor side effects can be a good sign. It means your body's immune system is starting to work properly and is fighting the cancer cells. So some doctors think that a minor response like this is better than no side effects at all.
How long will these side effects last?
These side effects usually go away within two to three days. For some people, they feel better after urinating and passing out the medicine in their bladder. However, if your symptoms last more than three days, or if they are very severe, be sure to talk to your doctor.
How to prepare for BCG treatment?
The doctor will give you some instructions the day before the treatment.
- Avoid consuming caffeine-containing beverages (coffee, tea).
- Urinate thoroughly and empty your bladder before treatment.
- Don't drink a lot of water the morning of your treatment. Staying slightly dehydrated will help keep the medicine in your bladder for about two hours.
- Most importantly: If you are taking antibiotics for any other reason, tell your doctor about it, as antibiotics can interfere with the success of BCG treatment.
During the treatment, the area where the catheter is inserted is numbed. Then, the BCG vaccine is injected into the bladder through the catheter, and the catheter is removed. After that, you need to hold off on urinating for as long as possible, about 2 hours.
Very important: Is BCG treatment contagious to others?
Yes, you need to be very careful about this. Since the BCG vaccine contains live bacteria, you can infect others through your urine within the first 6 hours after treatment. Therefore, be sure to follow these safety measures:
- Do not use public toilets. Only use your own toilet.
- Sit down when urinating. (Men can also avoid spilling urine by sitting down during this time.)
- After urinating for two hours after taking the medicine, drink plenty of water.
- How to clean the toilet: After you pee, pour about two cups of bleach into the toilet, close the toilet lid, let it sit for 15-20 minutes, and then flush. Do this every time.
- If you get urine on your clothes, wash them separately immediately, not with other clothes.
- Avoid sexual intercourse for a few days after treatment. Also, it is essential to use a condom every time you have sex during the entire treatment period.
How successful is BCG treatment?
BCG is currently the most effective treatment for early-stage bladder cancer.
- After BCG treatment, about 70% of patients achieve complete remission.
- However, for some people (about 20%-30%) this treatment may not work properly. These people are called "BCG unresponsive".
- Sometimes, the cancer can recur after treatment. But even if it does, BCG helps prevent it from becoming invasive cancer.
Regardless of these statistics, it is important to remember that the best and most effective treatment option we have at this time is BCG. Therefore, it is very important to follow the treatment exactly as the doctor recommends and to undergo tests like cystoscopy on time.
Take-Home Message
- BCG is a treatment that stimulates your own immune system to fight cancer.
- Side effects like fever and urinary tract infection are common and may indicate that the treatment is working.
- But if the fever is higher than 101.3 degrees F, it's an emergency. Tell your doctor right away.
- There is a risk of infection in your urine for the first 6 hours after treatment, so be sure to take safety precautions, such as flushing the toilet with bleach.
- It is mandatory to use a condom during sexual intercourse during the entire period of treatment.
- This is a very effective treatment. Stay in regular contact with your doctor and get the proper tests and treatments.
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