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BCG Shortage

3 weeks 3 days ago #58652 by Atlanta51
67 year old male diagnosed with T1 over a year ago. Two TURBTS and 9 BCG treatments before the recent shortage. My urologist also recommended monthly gemcitabine treatments (12 in total).

I solicited the opinion of a well known expert at the Emory Winship Cancer center. He highly recommended AGAINST the gemcitabine treatments (side effects, my test results which indicated a lack of cancer cells microscopically, etc.). He did seem to focus on BCG for 1 year, subject to subsequent exams and tests.

My circumstances are different from yours (CIS), but I would highly recommend you solicit another opinion from a well respected resource. I hope everything goes well for you.

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4 weeks 1 day ago - 4 weeks 1 day ago #58627 by Alan
Welcome sixftseven,

For sure BCG is the most used agent in this country. I am hearing the shortage is slowing down but, others may have more accurate info. Gemcitabine along with mitomycin along with other chemo washes have also been used effectively. The stats I have seen....and I never totally trust any study because of conflicts etc that BCG and the other treatments are pretty close in effectiveness. Plus, some people will react to each agent differently, so who knows.

Usually after the TURB most people/docs will wait 6-8 weeks for healing so you may have a little time to do further research and also locate someone with BCG. I have to admit I like the idea of immunotherapy vs the chemo wash but, if either works who cares. I am bookmarking just one study that discusses what we have already opined on. Just copy and paste: https://www.uptodate.com/contents/bladder-cancer-treatment-non-muscle-invasive-superficial-cancer-beyond-the-basicshttps://www.uptodate.com/contents/bladder-cancer-treatment-non-muscle-invasive-superficial-cancer-beyond-the-basics

In the body of that study is "Some people who are at intermediate risk of recurrence will be advised to have either a full six-week course of intravesical chemotherapy, most commonly mitomycin or epirubicin (see 'Intravesical chemotherapy' below), or intravesical immunotherapy with Bacillus Calmette-Guerin (BCG) (see 'Intravesical BCG' below). Both kinds of therapy usually involve additional booster treatments for up to one year (maintenance therapy).

DX 5/6/2008 TAG3 papillary tumor .5 CM in size. 2 TURBS followed by 6 instillations of BCG weekly with a second round of 6 after a 6 week wait.

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4 weeks 1 day ago #58626 by SIXFTSEVEN
65Y/O male recently diagnosed with Stage 0 CIS non invasive. Standard of care calls for 6 week treatment of BCG.
BCG is currently non-available or "iffy". My urologist wants to use a 6 week therapy of Gemcitabine instilled in the bladder. He claims that this has been used in Europe for a number of years and the literature supports the use of it over the BCG that is available in Europe. He did state that it has only been used in the US for @ 4yrs so there is a limited amount of data available here. I trust my D., but I would like other opinions here. BTW I have also contacted another Urologist and an Oncologist. They both have heard of this although the Urologist does not performthis. The Oncologist has consulted with a few Urologists about this treatment. I can't have the BCG yet because of 3+blood in my urine. I had a TURB @ 1 month ago. Comments please!

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