Confused about the BCG schedule I’m on

1 month 4 weeks ago - 1 month 4 weeks ago #62095 by Alan
Replied by Alan on topic Confused about the BCG schedule I’m on
1st, there are many protocols. The SWOG is proven and effective. The 3 month wait then 3 weekly graduating eventually to 6 months with 3 weekly induction are the hallmark of SWOG. The most important item is the continued vigilance of the cystoscopy. It is the gold standard along with BCG.

You'll note at the end of my signature I had 6 weeks on, 6 off and another 6 weeks on BCG. That was it. Partly because my tumor was small, caught early, and every instillation, every scope is invasive even if minimal with infections, scarring as possible complications. I still had regular scopes. My URO was either an intern or resident under Dr. Lamm when he was in San Antonio before Phoenix 40+ years ago. There is no absolute regimen except to say it is obvious BCG does work! 

Lesson? Everyone and every case is different.

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.
The following user(s) said Thank You: opaz_67

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2 months 11 hours ago #62092 by opaz_67
Hi, hope you’re doing ok. If you’re not at the moment, I send my love and good vibes to you.  

I'm on the 3-year BCG schedule for high risk non muscle invasive bladder
cancer. I’m assuming I’m on the SWOG protocol because it’s always the SWOG
protocol, right? That’s not a rhetorical question.
All the info I can find about SWOG tells me that after the 6-week induction, I should get one
3-week maintenance dose after 3 months, then another dose after 6 months and
then a dose after 12 months (i.e. after the first 2 maintenance doses, the gap
between doses extends from 3 months to 6 months).  
Problem is, as you’ll see from the attachment, that’s not what’s happening in my case. They’ve
already given me 3 maintenance doses with only a 3-month gap between them and
in January I’m about to get a 4th dose with only a 3-month gap.
This bothers me because I’ve been getting some bad side effects from the BCG (i.e. I sometimes
need a Tramadol) so I don’t want to have more BCG than necessary in case the
side effects get so bad I have to stop the treatment altogether.
I emailed my urologist and asked him about it but he just attached a SWOG schedule and said
see you in Jan. Suspect he speed read my query. Or it could be I’m misunderstanding
something. Anyhow I’d be grateful for your thoughts.

I'm a Brit living in France. I was diagnosed with high risk non-muscle invasive bladder cancer in 2021 and I'm being treated with BCG, so far successfully. I thank the Lord and the French health service. Amor Fati

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