Need to understand how BCG is/should be used.

Thank you soo much, In fact, your two responses have answered my 'fear of the unknown' and confusion issues. Wow, it is comforting to have such a resource to go to, such as your Society.

Thanks again,

PoppyPaul

PoppyPaul,

It would be real nice if there was ONE right answer, and it was the same for everyone. That is not the case - each of may respond to treatment differently, treatments differ, doctors differ, and the knowledge base is is described in terms of response percentages.

The article mentioned discusses what needs to be considered - then clinician input about the individual is needed. Sorry, few direct answers.

Treatment can (and does) vary depending on the bladder cancer - high grade or low grade, papillary or CIS OR one of the less common cancers. There are competing opinions on what is the best course to take. Once the cancer is "not found" the return time can be weeks to years; a large percentage of bladder cancers will eventually return, thus the need for long term check-ups.

Papillary tumors may be best treated with TURBT, or may have BCG following TURBT. CIS (by one school) is treated, in place without prior removal) with BCG or other potion. So, BCG *is* given with cancer present - that is my situation.

I have not give you the answers we all want, "When do we stop trying and go the RC route?" I would love to know the answer.

Give a read, look for yourself, and quiz your care team for specific answers for your situation.

Best
Jack

Thanks you for your frank response. It was reassuring that when my urologist said two more BCG's and the bladder comes out depends on my personal situation at the time. I'm okay if it has to come out, but that's the last thing I'd prefer. You have gone way past two, that's encouraging to hear.

Question: What can one expect after BCG as far as the time it buys you until you are told it's back. Is there a ball park time period?

Is it true that BCG should not be given if you have cancer present?

I've been out all day and will read the article you recommended tonight.

PoppyPaul

PoppyPaul,

People here report a number of "differences" in how their doctors treat and advise about BCG. This has been my experience also. In practice, I have found that there is NO universal standard that is routinely applied.

Below I provide a link to an article, "Expert consensus document: Consensus statement on best practice management regarding the use of intravesical immunotherapy with BCG for bladder cancer. Many of the group are well known and respected names in the bladder cancer field. Unfortunately, when it comes to my or your bladder cancer, we need to go beyond the statistics and find a doctor who will work with us as an individual. Published research can only go so far. That said...

The article is some 62 pages long. The meat is in the first 10 or so pages, ending shortly after the first set of graphs. The article is well organized into sections devoted to specific issues - browse through all of it.

I am in your boat - but a bit further along; I have gone from clear scopes back to cancer 3 times and have gone well past two rounds of BCG. My individual situation has been carefully considered by my care team. Much depends on individual circumstances. Although I would like to avoid the RC, my goal is to live, not to keep the bladder.

Read the article - It covers our questions very well, I found this helpful. I hope it helps you.

www.nature.com/nrurol/journal/v12/n4/full/nrurol.2015.58.html

Best
Jack

I have had unsuccessful and successful series of BCG treatments. I am now cancer free. My doctor said I can only have two more BCG regiments. After that my bladder has to come out. Also he said that BCG can only be give when there is no cancer in my bladder???? I am scheduled to start another BCG regiment in three weeks. Does that put me one step closer to having top remove my bladder???