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I did it again...and survived!

8 years 6 months ago #32397 by Patricia
The use of TheraCys may cause tuberculin sensitivity. Since this is a valuable aid in the diagnosis of tuberculosis, it may be advisable to determine the tuberculin reactivity by testing before treatment......
pat

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8 years 6 months ago #32388 by mmc
That's right Sara Anne, it 'could' (I'm not sure it is always)make you react to a TB test.

What Lamm is explaining is that they can do a similar thing with BCG to test skin sensitivity which would have a correlation to your sensitivety to the BCG.

Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results....distant mets
2/2014 ct result...spread to liver, kidneys, and lymph...

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8 years 6 months ago #32387 by Nix
You are right. My Internist did the "patch test" before I started BCG, because he said from that point on I would test "positive" and he thought it would be a good thing to have in my file, the "positive" was caused by the BCG.

Nancy

Nancy S
Ta CIS
dx Ta 11/06
dx Ta CIS 10/07

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8 years 6 months ago #32386 by sara.anne
Doesn't BCG cross react with TB on a skin test? Thought I read somewhere that it did, and that those of us who have had it might test positive. If so, anyone who already tests positive on a TB skin test would have a positive reaction to BCG. ??????

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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8 years 6 months ago #32385 by Nix
Very interesting, Mike. That would have certainly helped you out in the very beginning.
I am sure I would have tested fine, since I did get 24 - only the 24th was a problem. I guess my problem is because my Uro used 100% (or what they consider 100%) for at least 18 of the doses).
We still don't know if it is OK to start out with a lesser amount.
Once a patient shows too much of a reaction, Dr Lamm did tell me that the Uro can also "heat" the BCG.

We go as low as 1%. You can also reduce retention to 30 minutes or less.
I also sometimes give heat inactivated BCG to those who do not tolerate
live BCG.
Don Lamm, MD


Thanks for writing Dr Lamm with this question

Nancy

Nancy S
Ta CIS
dx Ta 11/06
dx Ta CIS 10/07

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8 years 6 months ago #32384 by mmc
I asked Dr. Lamm about the sensitivity testing for determing dose. Here is my question and his response:

Question:

Is BCG too risky to use in tiny doses subcutaneously in order to test a patient's sensitivity? It seems like many people drop out (myself included back in 2006) of BCG treatment due to severe reaction. Your research and posting seem to indicate that lower dose strength does not have decreased efficacy. Therefore, it seems like it would make sense to start people on 1% or 5% and then increase if required to get the reaction desired rather than going the other direction of starting high and reducing.

Just wondering if there is some way to test patients (maybe not researched yet?) for thier individual sensitivity to BCG so that urologists could set the dose to the patient and not just by personal preference. I know some start at 50%, 33%, or full. Patients react differently so it seems to make sense to find a way to tune to the individual patient.

Seems like less dropouts would mean more lives saved.


Dr. Lamm Response:

Yes, Mike. I quite routinely give percutaneous BCG. It is not injected, but given by the TINE technique- like a smallpox vaccination. That does provide some measure of immune response.


So folks may want to ask their doctors about this if they are going to start on BCG.

Mike

Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results....distant mets
2/2014 ct result...spread to liver, kidneys, and lymph...

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