BCG Preparation Question

7 months 5 days ago #60648 by Jack R
Replied by Jack R on topic BCG Preparation Question

The work of Dr. Lamm established the "basics" of procedure and likelihood of BCG success. Everyone it seems, wants to tinker with the procedures, hoping to increase the success rate. Items you have mentioned - including but not limited to, baking soda and avoidance of numbing lubricants during induction - have been suggested by various doctors and groups. I have yet to see any any of these suggestions gain wide acceptance.

Dr. Lamm has suggested a "second induction" of 6 additional doses in select patients who did not initially respond to BCG treatment; he also recommended maintenance BCG for those who do respond. The only additional recommendation I recall was for a vitamin preparation he endorsed.

Only you and your doctor know your situation. It appears that he is following generally accepted guidelines.

For us as patients, perhaps the best we can do i keep ourselves as healthy and fit as we possibly can. Always always check with your doctor for her/his suggestions to improve outcomes, and ask the doc before adding any drugs or supplements. 

Google Donald Lamm & BCG for an overwhelming amount of info.


6/2015 HG Papillary & CIS
3 Years and 30 BCG/BCG+Inf
Tis CIS comes back.
BC clear as of 5/17 !
RCC found in my one & only kidney 10/17
Begin Chemo; Cisplatin and Gemzar
8/18 begin Chemo# 3
Begin year 4 with cis
2/19 Chemo #4
9/19 NED again :)
1/2020 CIS is back
Tried Keytruda, stopped by side effects
Workin on a new plan for 2021

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7 months 5 days ago #60647 by joea73
Replied by joea73 on topic BCG Preparation Question
BCG has long-lasting efficacy.  Dr. Ashish Kamat of MD Andersons Cancer Center in Texas had mentioned by showing a study that though the complete response rate (no recurrence and no progression) was 55% for CIS after the initial 6 weeks induction course, it increased to 84% after the first 3 weeks maintenance course.  I watched a  case study video by three urologists recently.  In the video, Dr. Peter Black of the University of British Columbia mentioned that for CIS only patient, he does not even do a cystoscopy after the 6 weeks BCG and wait till after the completion of the first 3 weeks maintenance course as he recognizes the longevity of BCG effectiveness.

I am a bit concerned about you are scheduled for another 6 weeks BCG treatment, as the standard protocol for BCG treatment for CIS is  6 weeks induction course and followed by 3 weeks of maintenance at 3 months, 6 months, 12 months, 18 months, 24 months, 30 months.   Dr.Kamat is not recommending 6 weeks followed by 6 weeks of treatment.    

Below is the link to the video by Dr. Kamat.   He starts talking about BCG treatment at 8:30 


I would not do anything except drinking lots of water/liquid after BCG as Sara suggested to lessen the side effect.  It is a good idea to avoid coffee, soda, spicy food, and acid food to prevent irritation of the bladder, which will be exposed to urine by BCG bacteria breaks the protective lining of the bladder.  This suggestion was given by a doctor for patients who have interstitial cystitis due to UTI/Bacteria infection to the lining of the bladder.   BCG is live weakened tuberculosis causing bacteria.  So, over 30% of BCG patients experience cystitis of the bladder (urgency, frequency, and pain).  


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7 months 6 days ago #60646 by sara.anne
Replied by sara.anne on topic BCG Preparation Question
Hi Clyde!

First, a lot of your questions should be put to your doctor.  Especially with regard to Lipitor and other meds.  And I definitely would NOT fiddle with things such as supplements/baking soda.  BCG has been intended to be used in most cases just in normal situations.  Anything else, especially without consulting with your doc is asking for trouble and you risk reducing its effects.  And fasting?  I think not.  You appear to be consulting the "Old Wives' Tales" medical sites!!  The only amateur advice that makes sense to me is to start drinking some fluid AFTER BCG to help wash it through.

If s lot of your CIS disappeared after the first round, I would be optimistic about the second.

Sara Anne

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

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7 months 6 days ago #60644 by Clyde
BCG Preparation Question was created by Clyde
Hello All,

I will be starting my second round of 6 BCG treatments in a few week. Unfortunately I still had some CIS in my bladder after completing the initial 6 rounds on BCG. The Dr thinks there is still at least a 50% chance BCG will work this time. I'm just over 3 months out from completing the first round.

Is there anything I can do to assist the BCG be successful? 

For example I have heard that I shouldn't take my lipitor medication prior to infusion. I have also read some hospitals and Dr's don't want lidocaine used as a lubricant with the BCG because of it's acidity. Although my Dr doesn't think it is a problem. I have heard if you take some baking soda that it will help raise your PH level which would be good. Someone had suggested that if you fast for 24-48 prior to BCG that would help. I don't know whether to take supplements to boost my immunity prior to BCG or cut out all supplements. 

So, I'm not sure how to best prepare and put myself in the best condition for BCG to work. Perhaps someone that has had success with BCG would share what if anything they did to prepare for BCG.



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