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BCG .. the good bad and ugly

4 years 5 months ago #50924 by jroza1
As someone pointed out all of our journeys are unique, but this is what my doctor sent to me. The removed a high grade low stage papillary tumor.

Pathology Came back...
This is the recommendation from my doctor...

There is another therapy we should consider. This is called immunotherapy (immune system related therapy). This is done by placing a small catheter into the bladder and putting in a small amount of liquid containing the vaccine for tuberculosis. This is done once a week for 6 weeks starting 3 weeks after the surgery. It is then repeated once a week for 3 weeks at 3 months, 6 months, 12 months, and 18 months after surgery for a total of 27 treatments.

Here is a guideline analysis of this treatment:

However, in this high-risk group, maintenance BCG is superior to mitomycin C with or without maintenance. In our single-arm meta-analysis of randomized controlled trials of high-risk patients, the estimated five-year recurrence rate was 34% in patients receiving TURBT and BCG maintenance and 62% with mitomycin C maintenance. The meta-analysis of all risk groups found that, compared with TURBT and mitomycin C maintenance, TURBT and BCG maintenance therapy reduced recurrence by 17% (95% CI: 7, 26). In addition, there are limited data suggesting a trend to preventing progression with maintenance BCG. The progression in one study of 380 patients was reduced by 5% (95% CI: -1, 11) with TURBT plus BCG maintenance when compared with TURBT plus mitomycin C maintenance.84 Although maintenance therapy reduces recurrence and may reduce progression, the side effects and discomfort of the treatment and possibly the costs of the treatment may outweigh the benefits for some patients. Thus, discussion of the tradeoffs and consideration of patient preferences is important before beginning or continuing maintenance therapy.
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4 years 5 months ago #50923 by Razorbacktusk
Am wondering what the % is of our cancer returning after 1 year of BCG maintenance? and how effective BCG is in keeping it away??

Feb 1st 2016 TUR grade 2, removed were 2 tumors and many tiny nodes, the 2 large ones were 3.5cm
BCG maintenance in progress

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4 years 5 months ago - 4 years 5 months ago #50892 by Razorbacktusk
2nd BCG done and it was a breeze, BUT an FYI we need to eat and drink normally up to treatment time.. my nurse said.
i could not give a urine sample so they had to use a cath to get it. and then did the BCG,

that cath was larger and still had zero issues with it.

Feb 1st 2016 TUR grade 2, removed were 2 tumors and many tiny nodes, the 2 large ones were 3.5cm
BCG maintenance in progress

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4 years 5 months ago - 4 years 5 months ago #50881 by Alan
Yup, you don't want to fly the next day after. Once I had 3-4 installations, I found I had 20-30 seconds once the urge hit to know where the restroom was. Thankfully, that is a distant memory and hopefully ya'll will put this behind also.

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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4 years 5 months ago #50878 by jroza1
Thanks for the feedback. I too have a desk job (Vp of Sales) and thankfully I can work from home, but they only do treatments (usually) Tuesdays and Wednesdays for staffing and clerical reasons. Just means I have no fly days...

Thanks guys

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4 years 5 months ago #50877 by jeffrx

jroza1 wrote: were you able to work effectively? Or did you not work during treatment?


I had treatment on Thursday afternoons, so I proactively took half-day Thursdays and took off those 6 Fridays. I probably could have worked 4 of the 6 Fridays (the last 2 treatments were worse and the fatigue lingered for a few days). For the first 3 treatments, I was able to exercise the night of treatment, including lifting weights and going on a treadmill.

I'm sure everyone responds differently though. It also depends on the demands of your job. I work a desk job and am able to work from home, so it's easier for me than it would be for a person doing strenuous work.

12/2015 - TURBT, non-invasive T1, mixed grade, 3 tumors
1/2016 - Begin BCG weekly for 6 weeks
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