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BCG Dosage Question

10 years 9 months ago #14173 by Patricia
As this most recent article states..."Research Continues on dosages..........
http://www.webmd.com/cancer/bladder-cancer/bacillus-calmette-guerin-bcg-for-bladder-cancer

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10 years 9 months ago #14170 by wsilberstein

I wonder if they are prescribing this treatment by rote alone.

Well, we know it works, but I don't know if there are any conlusive studies comparing doses. An article in European Urology Volume 52, Issue 5, Pages 1300-1302 (November 2007) "What is the Optimal BCG Dose in Non–Muscle-Invasive Bladder Cancer?" at http://www.europeanurology.com/article/PIIS0302283807007117/fulltext concludes "apparently full-dose BCG is not necessary in all patients. Lower doses, usually one-third or one-half dose, is effective, although data in high-risk patients are not conclusive. For that, the results of EORTC study 30962 will hopefully give an answer. However, in all reports toxicity with lower doses is significantly decreased. So far the lower limit of low was not well defined, but this new CUETO study indicates that, although not statistically significant, one sixth of the full dose is less effective than one third of the full dose, and a further reduction in toxicity is not observed."
I hope the link works as I got to it through several links. If not, Google "BCG dose"

-Warren
TaG3 + CIS 12/2000. TURB + Mitomycin C (No BCG)
Urethral stricture, urethroplasty 10/2009
CIS 11/2010 treated with BCG. CIS 5/2012 treated with BCG/interferon
T1G3 1/2013. Radical Cystectomy 3/5/2013, No invasive cancer. CIS in right ureter.
Incontinent. AUS implant 2/2014. AUS explant...

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10 years 9 months ago #14168 by Rosemary
Connie,

You pose a very intelligent question.
The only thing that I personally am sure of is that reducing the dosage did nothing to allay any of the side I effects that I experienced as a result of BCG treatments even though the research ruled that it should have.
I do not know what that means in the scheme of things.
Would a little have worked just as well as a lot???
I truly don't know if anyone knows...
I try to ask the Docs' but there seems to be no answer.
I wonder if they are prescribing this treatment by rote alone.
It sure seems that way.
Good discussion question...
Buds,
Rosemary

Rosemary
Age - 55
T1 G3 - Tumor free 2 yrs 3 months
Dx January 2006

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10 years 9 months ago #14161 by ConnieOnAQuest
I've read in several places that cutting BCG dosage by a third, a half, or even two-thirds gives the same results as a full dose, and there are fewer/milder side effects. If that's the case, why are we routinely given more of a potentially toxic medicine than we need? Just wondering. Am I missing something here? Has the "standard" dosage ever been reconsidered? I would like to read up on this if anyone can direct me to some information. Also, if one is having intolerable side effects, is it better to skip a treatment or dilute it?

Thanks.

Connie

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