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9 years 8 months ago #24629 by Alan
Sara Anne,

Some have posted about the micro bacterial studies on those that can't tolerate BCG. Hope I am not confusing the issue with info. For me I am going foreward with just what my URO suggested: 6 on, 6 off, 6 more and done & hopefully gone.

Journal of Urology article: http://www.jurology.com/article/S0022-5347(08)03046-2/abstract

Plus clinical trials: http://www.clinicaltrials.gov/ct2/show/NCT00406068?show_locs=Y#locn

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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9 years 8 months ago - 9 years 8 months ago #24628 by Alan
Sara Anne,

For whatever it's worth. My URO had me do 6 weekly installations, then 6 weeks off then 6 more weekly treatments. That is all he wants me to do. Don't know if part of this is my tumor was tiny (.5CM) and papillary or another idea. I know that he is concerned about continual installations increasing complications.

An article from the Journal of Urology in the body of the article supports the 6 and 6 protocol as being statistically equal to the 6 plus maintenance. They will let you register free as a guest. It's buried in about the middle. See:
http://www.jurology.com/article/PIIS0022534705667936/fulltext.

Here's the body:A recent study by the Southwest Oncology group suggested a 3-week booster schedule to be effective in reducing tumor recurrence in high risk patients and protecting from disease progression. Considering the 7-year followup, recurrence was reduced by half (from 52% to 25%) with maximal benefit in patients with rapidly recurring tumors. The apparent advantage of this regimen in reducing disease progression did not appear to manifest until 2 years after induction was completed. However, in accessing results for all tumor patients receiving maintenance BCG versus those receiving no maintenance, differences were not particularly striking. For example, in examining maintenance treatment for stages Ta and T1 tumors versus controls, there is an early decrease in the control group at the 2.5 to 3 year interval before and following which the slopes of tumor-free status appear to be similar for both groups. Furthermore, in assessing maintenance therapy for carcinoma in situ, there is an early decrease in recurrence-free status (or persistence) in the “no maintenance” group until the 2-year interval when rates of tumor recurrence become similar between the 2 groups. Considering the heterogeneity of tumor responsiveness, host factors and variability of immune reactivity much remains to be determined in optimizing treatments with BCG to determine whether disease recurrence or progression can be prevented.

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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9 years 8 months ago #24625 by sara.anne
Yes, Jack. I get checked for blood and infections before every BCG. My uro called this "BCG-induced" cystitis, and because of it he cancelled my session last week. I was feeling close to normal today and the urine check did not show infection or blood.

SA

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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9 years 8 months ago #24624 by Moonerj
Hi Sara Anne

Are you sure that the cystitis has cleared. Did you take meds to clear the cystitis? Any bladder infection I had during BCG treatments, I was given antibiotics for 7 days, and had to wait 2 weeks until my next treatment.
My last 8 maintenance treatments I had to take the infection meds 2 hours after each treatment, just in case I got another infection.
My maintenance treatments had more side effects that the weekly treatments.
Night and day differences.
Also my urine was tested for a bladder infection before each of my last 8 treatments. This only took 2 minutes for the Head Nurse to check.
I wish I could help your more.
Jack

TA Grade 1
3 Turbts
30 BCG Treatments
Cancer Free since Nov 2007

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9 years 8 months ago #24622 by sara.anne
Just had my second of three maintenance BCG's...it had to be postponed from last week because I got a real case of BCG-cystitis. We went today at half-strength. All afternoon I have been miserable...lots of urgency, burning...all the usual.
Except that this time I am bleeding a LOT. Did call my uro and he asked a bunch of questions and then told me to drink GALLONS of water. This has been going on for about three hours.

My primary question is: what would happen if I don't do any more BCG? I had the first six with minimal problems..just fatigue. Then during the first maintenance set last September I got hit with rampant diarrhea (yes, it can be a side effect according to the manufacturer) and had to delay one treatment, but did get through all three.

Do you think I have had enough to be effective at all in preventing recurrence of CIS? I don't want to consider quitting if it would negate all that I have been through, but this is getting BAD.

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator

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