Carcinoma In Situ diagnosis

9 months 3 weeks ago #60217 by Clyde
Replied by Clyde on topic Carcinoma In Situ diagnosis
Finished BCG installation # 6 today. No side effects except for some burning for a few hours. Now I have to wait until February for a scope and cytology test to see if the treatments were effective. I'm hoping and praying that they work.
I did ask the nurse why I would pass blood after the first installation but none of the other ones and she suggested that it was probably from the insertion of the catheter and not the BCG.

I was also searching online to see how long your immune cells work at attacking the abnormal cells with BCG. I was trying to see if your immune cells only went after the bad cells while the BCG was in the bladder of if there is a lasting effect for hours, days or even weeks. But I couldn't find any definite answers.

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10 months 5 hours ago #60188 by Clyde
Replied by Clyde on topic Carcinoma In Situ diagnosis
I completed number 5 of 6 BCG treatments today. So far so good. I did notice a few days after treatment #4 I had some minor flu like symptoms for a day. I’m chalking that up to BCG. We’ll see if it happens again later in the week.

I did ask the nurse about using lidocaine prior to the catheter and she told me that is standard procedure with BCG.

I also asked the nurse why I would have blood and other particles coming out after my first BCG treatment. But then no blood, just normal looking urine for all the other ones. She wasn’t sure but suggested I could have had some lingering trauma from the cystoscopy I had a few days prior to the first BCG treatment. I was hoping the first treatment got rid of all the abnormal cells and the rest of the treatments were just scouting around and doing clean up ;)

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10 months 5 days ago #60168 by swarmy2007
Replied by swarmy2007 on topic Carcinoma In Situ diagnosis
My problem after having near 40 instillations is if I stand up to leave I void..... no stopping that fact. So lay on table and nap & read Bible. On the Lidocaine I have ask my doctors to not use it due to mess and fact it worsens the retention issues with me and they are adamant about using it.... for ease of catheter insertion. Truth is I'm such an old hand at doing this that catheter doesn't bother me much at all anymore. Also they tend to insert the cath immediately after lidocaine which makes no sense to me.... least give couple minutes to numb a bit? Just an added mess to me that prefer not have.

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10 months 5 days ago #60167 by Clyde
Replied by Clyde on topic Carcinoma In Situ diagnosis
Thanks for the link to the NCBI study. I read the report. One item noted that I found curious was they recommended not using lidocaine for the administration of BCG. I'm going to a National Cancer Center for my infusion of BCG and they use lidocaine prior to the catheter insertion. Not sure if it is a different variety of lidocaine or if the center deems the lidocaine has a insignificant impact on the BCG. I will ask the nurse next week.

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10 months 5 days ago #60166 by joea73
Replied by joea73 on topic Carcinoma In Situ diagnosis
I have noticed that many hospitals are not requiring the rolling anymore according to several patients' comments.

It is likely because the consensus among a medical community stated "when considering other practical issues for BCG administration, the Task Force determined that it is not necessary to rotate patients every 15 min post BCG instillation". See the section What are the most important practical aspects of administration of BCG? www.ncbi.nlm.nih.gov/pmc/articles/PMC5557323/


The detail explanation of why the rotation is not required is mentioned in the paper by Dr. Ashish Kamat of MD Anderson and others. txcercit.org/Files/publications/23540779.pdf

"An interesting practice among some urologists is to have patients lie recumbent during the instillation period and to have them rotate every15 minutes in an attempt to evenly expose the entire bladder surface to BCG. Although well intentioned, this rotisserie method does not seem to have any basis in the scientific literature. The elastic nature of the compliant bladder suggests that it changes size to accommodate the volume of fluid inside. Therefore, unless the instillation was incorrectly done and a large air pocket was introduced in the bladder, serial turning of the patient is not necessary. It is the authors’ practice to have patients lie recumbent for several minutes
after instillation of the BCG and then to allow them to ambulate normally during the 2-hour retention period."

Still, it would not hurt to rotate just in case there is a large air pocket as it could be the case. But, the consensus by urologists says we do not have to worry much on rotating.

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10 months 1 week ago #60164 by sara.anne
Replied by sara.anne on topic Carcinoma In Situ diagnosis
My urologist laughed at the rolling around stuff. Said it was an "old wives' tale" and that just living and breathing was enough to coat the bladder with the BCG.

Sara Anne

Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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