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Indication of Blood In Urine During BCG Treatment

1 month 1 week ago #58291 by DAVIDMATHEWS
Your post was very enlightening for me. I am due for BCG in a week or so. I did not see any responses (darn), to your post, anyway I will stay tuned it is still early. I will ask my doc questions in relation to your post.

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1 month 2 weeks ago #58228 by sara.anne
That is good news Nelson . I am also very impressed by the response from your care team . I wish that all patients would receive such an understanding and caring reply when they ask questions .

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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1 month 2 weeks ago #58225 by NelsJenn
Dear Sara and Alan,

I took your advise and contacted my urology team at UCSF about blood in my urine concern. Below was their response. Please know this response was given to me for my circumstance, and I wanted to share this with everyone. Your situation, if you have such a concern, may be different.

RESPONSE
=========
It is exciting that you have only one more treatment to go!
It is common to see moderate to sometimes large blood in urine on dipstick during BCG treatment.
As long as we do not see gross hematuria (visible blood in urine) and you are feeling well enough to get treatment, we keep on going.
I also would like you to know that we find negative for UTI after culturing urine when dipstick is positive for nitrite.
Dipstick is a good screening tool, but we look at history of dipstick results and also how a patient is doing and feeling.

Please not to restrict fluid 24 hours prior to treatment.
We advise you to limit fluid intake 4 hours prior to BCG so that the medication placed into your bladder won't be diluted with fluid.
There is no need to restrict fluid intake more than 4 hours before treatment.

It is wonderful that you are tolerating well to treatment.
You may see more side effects when you receive more treatments, but it is wonderful that we don't have to postpone your treatment due to side effects which happens sometimes.

Thanks to everyone for the support, Nelson

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1 month 2 weeks ago - 1 month 2 weeks ago #58224 by NelsJenn
Dear Alan and Sara,

Thank you for your responses. I am not so concerned about the issue of having a UTI. The urine tests at home and at the infusion center are consistent and indicate no UTI.

The blood in my urine test, however, does concern me. This urine test at home is not consistent with the urine test at the infusion center. There is no visible blood in my urine, both at home and at the infusion center. In fact, the color of my urine is yellow or clear, depending on how much water I have drank.

The urine test at home indicates that I have trace amount of blood in my urine which I am assuming is a positive result. And I am sure I am doing the test correctly (it's not rocket science).

This urine test at the infusion center, however, is indicating that there is large microscopic amounts of blood in my urine.

Perhaps, it's the test strips. Perhaps, it's not drinking liquids for 24 hours before the BCG treatment. Perhaps, blood in the urine is part of the BCG treatment. Or perhaps, my immune system has not responded to the BCG and the cancer cells are not being destroyed. These are the only variables that I can think of that might give me the different results between the urine tests or that I still have blood in my urine.

I am planning to repeat the urine test at home in a few days after my last BCG infusion, and I will contact my urology team about this.....

Shit. This #€%¥?!=+#~ is scaring me now.

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1 month 2 weeks ago #58222 by sara.anne
Nelson, I think that this is a question for your urology team. If you haven't done so already, please give them a call and let them know.

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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1 month 2 weeks ago - 1 month 2 weeks ago #58221 by Alan
BCG can and will irritate causing passing of blood sometimes. I know I did. It wasn't much.
I am not sure drinking less water before is a good idea. I'd trust your team making the calls on the cytology prior to installation....and I am not saying you shouldn't be vigilant and ask questions. Sure, you want to able to retain the treatment however the 2 hour holding period is simply a goal. By my last 3 of my last 6 inductions it was all I could do to hold for it 45-30 minutes.

If you have an UTI before induction or visible blood that is when they normally pass for a week due to possibility of BCG making things worse.

As far as side effects. Sounds like you are experiencing some of what most people report. Anytime we start thinking too much about BCG I always reminded myself this is doable and a lot easier than chemo that many endure systemically. You will get through this.

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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