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Why Mitomycin?
Hi Folks, just had my 2nd cystoscope / biopsy after a six week bcg series. My docs office called and said he would like to start a six week program of mitomycin. How is this different than the typical bcg compound / immunotherapy ?
I’ve heard of shortages of the tb stuff but is there another reason for the mitomycin besides shortage?
Thank you, rocksteady -
6 Replies
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Thanks Nomad, I was told yesterday that my doc got his hands on some bcg so I will start that 5/11/15.
I would like to thank everybody for your replies and concern.
Rock -
RE: Mitomycin, I was diagnosed with CIS. Have been clean for 18 months with the usual cysto/BCG routine. I am now being treated at MDAnderson due to relocation to TX. After a clear cysto last September, I should have had the usual 3 treatment course of BCG, however, it was not available to me at that time. MDA decided to put me on Mitomycin once a month for 6 months as an alternative protocol, and then have another cysto. Fortunately that was all good, except some spot of inflamation. They did follow-up biopsies to make sure nothing was lurking. All negative! Now I’m on 1/3 dose of BCG for 3 treatments. I’m having a lot of side effects this time, whereas I did not previously. They are saying that I’m getting a strong response from my immune system.
By the way, MDA no longer uses the Clorox protocol after BCG! They say you can use any toilet as long as it is high flo – not your home toilet for most people. I have been treated at 3 different facilities and each seem to have their own procedures.
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CIS is not something to fool around with. I suspect your urologist doesn’t want to wait if he cannot get BCG so is going to Mitomycin. But be sure you know a. what he found recently and b. the rationale for the switch.
SA
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator
OK, the only problem I had w/ the bcg was holding it in due to the burning otherwise it was tolerated well. It looks like I have flat urothelial carcinoma in situ and cystitis cystica with chronic inflammation.
You are right, all I can do is wait until my appt. and speak with the doc about treatment.
Thanks for your input, rocksteady
SA, thanks for the reply. Yes, I had a cystoscopy in the hospital with a biopsy after my first 6 week treatment. I have CIS. All I was told by my Dr.’s assistant was that my sample was positive for carcinoma. I have not spoke to the doc since the scope, done 4/17/15. I have an appt 5/11/15. His office called today and said he wanted to start the maintenance program with mitomycin at my 5/11 appt. I will call his office and ask for a copy of the path report. His practice does not have a patient portal that I am aware of.
Thanks again, will keep you posted.
rocksteady
This is a question that you need to discuss with your urologist. There could be several reasons that he switched to Mitomycin. The usual treatment plan consists of a six week series of BCG (which you have had) followed by maintenance doses about every three months until two years have passed.
As you know, there is currently a shortage of BCG due to manufacturing problems, and it could be that your urologist is unable to get any right now and is switching you to Mitomycin. Mitomycin is administered in a similar way as is BCG and is often used for patients who have problems tolerating BCG.
I am somewhat confused by your statement “just had my 2nd cystoscope / biopsy after a six week bcg series.” Usually cystoscopy is the urologist viewing the bladder via a small camera. Biopsies are not usually taken during this procedure, but rather during a TURB (transurethral resection of the bladder) under general anesthesia and the samples are sent to the pathologist for analysis. (I have known of patients where a small sample was taken during cyctoscopy OUCH but is is not usual.)
IF biopsy samples were taken and sent to the pathologist, you should get a copy of the path report and discuss this in detail with your urologist. There could be reasons from the path report which would explain the switch to Mitomycin.
Please let us know what happens.
Sara Anne
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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