Apparently, Esracain gel injected in my BCG treatment is identical with Lidocaine*. and the catheter is 8.
*Chief nurse said that no problem of compromising the BCG effectiveness (by using Ezracain) are known
In today's treatment, the nurse waited 5-10 minutes after injected the Esracain and prevented it from going out ,and that seemed to have helped (less pain); I also took 400mg Nurofen, 45 min. before we started so that might have affected too.
Re: pain management on the insertion of the catheter
To manage the pain on the insertion of the catheter, I have noticed most patients are administered local anesthetic Lidocaine first.
It depends upon the hospital if Lidocaine is used as default or use it for only those patients with pain.
Regarding the use of Lidocaine and lubricant's, Society of Immunotherapy and Cancer dose not recommend the use of Lidocaine or use of excessive lubricants because the use of lidocaine or excessive lubricants during catheterization has been shown to have inhibitory effects on BCG viability Also, with the use of local anesthetic, patients may not be able to feel/report a potentially traumatic catheterization. I
Also, it seems that the experience of the nurse in administering makes difference. Some patients request smaller catheter to reduce the pain. Usually, the standard size of a catheter is 14F and some patient used 10F.
1. Ask for a nurse who had many years of experience in administering intravesical BCG.
2. See if they can use a catheter smaller in its diameter than 14F which is the standard catheter.
3 . If it still hurts and tropical anesthetic is to be used i.e. Lidocaine or lubricant, try not use too much as it will reduce BCG effectiveness.
Incidentally, there are many important tips for BCG treatment are mentioned in the consensus report. For example, the report says it does not require to rotate every 15 minutes, and oral quinolones ( nor prior to BCG and not within 6 hours after BCG instilment) is recommended to reduce the side effects.
Sounds like you have been busy figuring things out and have a plan. I have seen gemcitabine mentioned often among other agents. Plus, I am sure your team has chosen this one per their experience and your situation.
Let's just trust this thing is already gone!
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.
Thanks so much. Just had telephone appt with 2nd opinion Doctor from Lahey clinic. I just was lookin for options prior to appt so I could bring it up. He answered all my questions and gave me new information which was very helpful. At this point cystoscopy with biopsies and cytology studies every 3 months and ct every 6 months. Let the bladder heal from the BCG treatments. If the cancer comes back will try gemcitabine before removing the bladder