The BCG schedule has not "changed." Different doctors take different approaches However, it has been shown that a maintenance regimen increases the effectiveness of the treatment and there are somewhat different patterns for the maintenance routine also.
If you haven't read it, you will find Dr. Lamm's discussion of BCG therapy interesting.
He is one of the experts on this treatment.
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
I started bcg back in 07. Had 1 per week for 6 weeks. No other treatments , but had cysto every month for 6 months then went to bi-monthly for 6 months, eventually to once a year. Was still on the once a year regimen when they spotted another cancer. Going thru the bcg again and just had my first treatment. Scheduled for the 6 week program again. was never aware of having to get maint. treatments periodically. My first go round back in 07 was at a cancer facility in Orlando , Fl. When did the maint. schedule change from what I had back in 07? by the way, the cancers all turned out to be negative. Would that have something to do with the frequency of the maint. schedule??
6 years 5 months ago - 6 years 5 months ago#43911by Markq
I'm going to start the 24 month maintenance treatment Monday and my Uro said this will be it. I'm going to talk to him about continuing on using Dr. Lamms protocol. From what I've read the effects of BCG eventually wane and risk of reocurrence begins to increase after a while. I'm only 41 years old so I would prefer to keep the cancer at bay using Dr. Lamms maintenance protocol rather than risk a reocurrance and potential stage progression at some point in the future. I think he'll go along if I show him Dr. Lamms protocol. If I had a low grade tumor I'd probably stop after this treatment and call it good. As to a 30 month treatment I'm not going to pursue that. Dr. Lamms latest protocol I saw on his website omits that cycle. Here's the link to Dr. Lamms answer on a BCG maintenance protocol question.
Kimberley, I had 6 BCG treatment right after DX and turb, then 3 more every three months for 1 year then 3 more every six months for two more years for a total of 30 treatments. My last follow up in December 2012, 4.5 years from a recurrenct was clear. If I am also clear in June 2013 I will go for yearly cystos.
My BCG maintenance schedule changed while I was on it, due to changes recommended by the current literature. I had been expecting to go out to 30 months (from the start), but ended up not having to have the last treatment (YAY). By now the BCG is just a distant memory, and come June I'll be at the 5-months cancer-free mark.
Small TA Grade 1, May-06; recur (2 tiny), same, June-08; TURBTs both times. BCG begun July-08, dosage to 1/3rd May-10, completed treatment December-11. All clear since 2008.
6 years 5 months ago - 6 years 5 months ago#43880by Alan
My URO studied under Dr.Lamm years ago when he was in San Antonio. There are many protocols. Mine had me do 6 on, then off 6 weeks, then followed with 6 more weeks and that was it. His reasoning was is there is risk in every treatment from TB to increased sensitivity from the solution to irritation of the the whole tract. You have to trust someone and go with it plus, everyone's situation is different. While my tumor was high grade it also was tiny and caught early. At almost 5 years out & clean, I still will get a yearly cystoscope and in between as my annual physical is 6 months in the middle I ask for a BC cytology screen. Who knows what is the exact best? Your tolerance of more treatments and your own body may give you the answers. Your 24 months of being clear is certainly a good note!
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.
Last edit: 6 years 5 months ago by Alan. Reason: clarity