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Low grade and BCG treatments

1 year 3 months ago #54702 by Eight15
Hi Jack,

Thank you for your reply and for providing me with that most informative website link. From what I gather, as this pertains to my situation, the expert guidelines for low grade recurrent bc is optional for the use of BCG. So I guess it's up to to Dr and the patients personal situation.

It's often written in this forum and others about how LG bc doesn't respond well to BCG, but I haven't found any info/studies regarding that. I know the guidelines suggest that it's optional, but it doesn't state anything about how effective it is.

Do you (or anyone reading this) know of any studies that would show stats as to outcomes for patients with low grade recurrent bc after being treated with BCG.

Thanks so much for your help!
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1 year 3 months ago #54699 by Jack R
Eight15,

Since I have the answer at at hand,

Regarding BCG and Low Grade Tumours, the following article is a good starting point.

'Expert consensus document: Consensus statement on best practice management regarding the use of intravesical immunotherapy with BCG for bladder cancer'

From, Nature Reviews Urology volume12, pages 225–235(2015)

Beginning on (about page 6) under the section header,

"Review of current guidelines on BCG use"

See the BCG recommendations for various initial presentations.

From the text, "Consensus exists for small, solitary, superficial low-grade tumours (Ta) with all groups agreeing that BCG is not indicated in this setting given the very low risk of disease progression."

The entire article discusses specific aspects of BCG decision making, and the contributor list includes well credentialed major researchers and clinicians.

Extensive footnotes provide further information and resources.

Full Article at:
http://www.nature.com/nrurol/journal/v12/n4/full/nrurol.2015.58.html

ALWAYS verify ANY recommendation or information from a publication or the internet with YOUR care team who knows YOUR situation. One size does not fit all.

Best,
Jack

What's with this Bleeding ? 6/2015
DX: HG Papillary & CIS
3 Years and 30 BCG/BCG+Inf
Tis CIS comes back.
BC clear as of 5/17 !
RCC found in my one (only) kidney 10/17
Begin Chemo; Cisplatin and Gemzar
8/18 begin Chemo , round 3
Begin year 4 with cis
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1 year 3 months ago #54695 by Eight15
Hi Sara.anne, I've often heard that BCG isn't as effective on low grade bc, but can't find any real medical info on this subject. I only hear this on message boards and have not heard any doctors state this. Can you, or anyone reading this, provide any details on studies/medical articles that confirm this? I was told by my urologist that it works well for recurrent bc. I'm about to have my 4th bcg treatment. Thanks so much!
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1 year 3 months ago #54694 by sara.anne
Joanne, what was the pathology of the first tumor? Was it low grade? BCG has been shown not to be as effective with low grade bladder cancer as it is with high grade. Low grade bladder cancer is usually treated by watchful waiting (cystoscopy every three months) and BCG is only used if the low grade keeps returning. Since yours has returned, BCG is indicated. But I just wondered if it was low grade at the beginning?

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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1 year 3 months ago #54691 by Joanne2
I was diagnosed with low grade superficial bladder cancer in Sept 2016. I had a somewhat small tumor removed, 1 dose of mitromician and 6 BCG treatments. I had a cystoscope every 3 months. In Nov 2017 my doctor found 3 small spots. In Dec 2017 I had those low grade spots removed. I begin a 3 course round of BCG on Feb 13. My doctor said this was not a BCG failure because it was still low grade. This was tough to swallow. I thank God I have a good doctor who found it and is pro active. I wish you luck with your treatments. Please keep us updated.
Joanne

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1 year 3 months ago #54690 by exsequor
No but I'm interested in knowing because I might be going this route, just had my second TURB's follow up pathology appt post poned from this afternoon until next Tuesday.

So I'll find out then if the results suggest BCG, or what. But I could very well be in the same or similar boat as you. So I am curious to find out more as well.

Heavy Wine Hematuria: 7/28/2017
Original DX: LG/NMIBC 1.7x1.5x2cm
1st TURB on 9/12/17
1st Pathology Results on 9/25/17
1st Scope Recheck on 1/12/18
2nd TURB on 1/23/18
2nd Pathology on February 2/13/18 (TBD)

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