Donna,
In my reading, I look to articles and information from peer-reviewed journals, reputable organizations and major cancer center hospitals. Pay-to-publish sources are ignored.
In brief, from my reading, the DOSAGE of BCG can be reduced to 1/3, 1/30 or even 1/100 in necessary and still be effective. (Dr. Lamm) I have not seen this statement contradicted.
There is greater question about the REACTION of the patient to the use of lower dosage BCG. Some sources say the side effects are lessened, others find there is no reduction in side effects.
MY experience. Following a catastrophic accident 12 years ago, I have ongoing chronic pain. BCG (along with a whole range of other inputs) caused bladder spasms set off unbearable nerve pain for 24 to 72 hours. I rely on heavy duty pain meds to get me through each dose of BCG - the pain is not eliminated, but becomes tolerable, then fades away.
Reduced doses of 1/30 and 1/100 did not reduce the pain for me. Others I have spoken to have gained relief with the reduced dosage. I have elected to stick with the full dose of BCG, there being nothing for me to lose or gain.
I would (and did) consider it worthwhile to try a reduced dose of BCG if the doctor is supportive of the idea. It would be wonderful if the reduced dose is tolerable for you.
Best,
Jack