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Gemcitabine vs. BCG

1 month 1 week ago #59419 by jabeck79
I have no other health issues, other than bladder cancer. Would have liked to try BCG Immunotherapy first, but I guess that is not an option.

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1 month 1 week ago #59418 by swarmy2007
Non Invasive High Grade T1-G3 for 3 1/2 years with 4 TURBT followed by BCG 1st 3 TURBT then developed BCG-Osis reaction so switched me to 6 weeks Gemzar/Gemcitibine since. Truth is with BCG the "Gold Standard" mine was returning 4-6 month intervals requiring another TURBT and all rest. Since went on the "Low Expectations" Gemzar I just got my 3rd 3 month "Clear Cystoscope" and am doing cysto x 3 months with 3 weeks Gemzar maintenance chemo between each scope. Each case is different this is who I am. God Bless and fight the vile disease with every tool you have.

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1 month 1 week ago - 1 month 1 week ago #59417 by Alan
Welcome jabeck79.

I see lots of questions so hopefully I won't be too confusing or miss many answers.

Low grade, non invasive cancer of the bladder is usually a "wait and watch" to see if there are any recurrences. As you have had 2 there may be some reason why your URO picked gemcitabine wrapped into this. It could be that practice is still having trouble getting BCG? Perhaps they have had more success with it. Is there a medical or pathological reason why it was chosen? BCG is usually not given in a first DX of low grade so there may be a clue. Yes, I would have questions about it also.

The biggest difference is one agent is a chemo wash where the other (BCG) is immunotherapy done to rev your system up. Do you have an immune system issue or past TB diagnosis or other health issues? That could be a decision factor.

From past reading from other posters and studies I have seen it does appear BCG is prefered with slightly better results. That does not mean that gemcitabine is not effective...there are posters that have had good results with this.

I hope I haven't confused the issue. None of us here are doctors so, I always say try and have your questions ready for your team. Chances are pretty good either agent will do good. Keep asking away and perhaps someone else have more insight or ideas!

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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1 month 1 week ago #59416 by jabeck79
Hello,

New Member, this is my first post. I am a 41 year old male diagnosed with Non Muscle Invasive Bladder Cancer Ta low value in August of 2019. I am currently on my second recurrence (3rd TURBT procedure scheduled for July). Non-smoker, however Mother who is 72 was also diagnosed with the same cancer. Would have enjoyed another 30 years before this diagnosis but this was the hand I was dealt.

After this procedure I plan to follow up with Intravesical treatment. While I thought I would be a candidate for BCG treatment it has been explained to me that "I am not sick enough" to be given BCG treatment and instead my treatment option is limited to Gemcitabine (8 weeks Consecutive) then followed up with Monthly installations for 10 additional months. If I were to qualify for BCG my understanding is this would be 6 weeks BCG. Obviously 6 catheters, is way more appealing then 18 catheters.

Putting the unpleasant catheter experience to the side, it has not really been explained to me (Or I have not asked the right questions) the difference between immunotherapy vs. chemotherapy for someone in my position. While I have reviewed some scientific information regarding Gemcitabine vs. BCG, there does not appear to be anything conclusive as to the benefit Gemcitabine over BCG. Is Gemcitabine an experimental treatment? BCG has been used for over 40 years as a proven treatment for NMIBC. Has anyone had experience with Gemcitabine administered via catheter for an entire year with good results?

I am aware there is a BCG shortage which has Doctors putting people in my position on alternative treatments. However it is frustrating that there is a possibility I might very well benefit from Immunotherapy vs. Chemotherapy, but Immunotherapy is not an option even after my third TURBT.

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