What is BCG?

BCG is a type of immunotherapy used to treat high grade non muscle invasive bladder cancer (cancer which affects the bladder lining not the bladder muscle) to prevent the cancer from coming back (recurrence) and spreading (progressing). It is put into the bladder through a catheter and is given once a week for a period of six weeks. This is known as a treatment course. Following this you will require a cystoscopy.

Following the cystoscopy I will usually recommend a maintenance course this means that BCG is given again once a week for 3 weeks approximately 4-6 weeks after your cystoscopy. The maintenance course will then involve further BCG (once a week for three weeks) every 6 months for a 1 year. This regimen has been shown to reduce both recurrence and progression.

Are there any reasons why I should not have BCG?

1. If you have a urinary tract infection (UTI).
2. If you are taking immunosuppressive medication or have a disorder of your immune system.
3. If you are breast-feeding.
4. If you are pregnant, possibly pregnant or trying to conceive.
5. If you have had a flu or shingles vaccine within the last 6 weeks.

What happens during treatment?

BCG is put into your bladder through the catheter. The catheter will then be removed and you will be asked not to pass urine for 1 hour. You can walk about when the BCG is in your bladder.

How long will the treatment take?

You will need to keep the BCG in the bladder for 1 hour.

Are there any side-effects?

Most procedures have a potential for side-effects. You should be reassured that, although all these complications are well-recognised, the majority of patients do not suffer any problems after a urological procedure.

Common (greater than 1 in 10)

1. Urinary tract infection requiring postponement of the next dose of BCG
2. Some bladder discomfort after treatment
3. Flu-like symptoms which can persist for 2-3 days
4. Frequency and urgency of urination which can persist for 2-3 days
5. Blood/debris in the urine

Occasional (between 1 in 10 and 1 in 50)

1. Stricture of the urethra (water pipe) following repeated use of a catheter
2. A number of inflammatory reactions which can affect various parts of the body (the liver, joints and the back of the eye)

Rare (less than 1 in 50)

1. Persistent or severe pain after treatment, sometimes requiring removal of the bladder
2. Generalised and potentially serious infection with the BCG bacteria requiring treatment in hospital with powerful antibiotics. This is not TB and there is no risk of catching TB from the treatment