Intravesical therapy is when a treatment is placed directly into the bladder through a catheter inserted into the urethra, rather than being given by mouth or injected into a vein. Special medications that help the immune system fight the cancer are then inserted directly into the bladder. There are two main types of intravesical therapy – intravesical immunotherapy and intravesical chemotherapy.
Immunotherapy is the use of your body’s immune system to attack the cancerous cells that are responsible for the disease.
To fight bladder cancer recurrence, your doctor may insert immune-stimulating agents – either Bacillus Calmette-Guerin (BCG) alone or with interferon – directly into your bladder to recruit your body’s immune system to destroy the tumor cells. BCG causes an immune reaction that has been shown to kill cancer cells of the lining of the bladder.
BCG is generally used for patients with high grade non-muscle invasive bladder cancer because research studies have shown that it can reduce the risk of cancer recurrence and progression.
Most commonly, urologists recommend instilling BCG once a week for six weeks, referred to as “induction therapy”. This is typically performed in a doctor’s office or clinic after the bladder has healed from the resection (TURBT). Your urologist may also suggest BCG “maintenance therapy” (additional cycles of BCG after the initial induction course). Induction therapy plus intermittent maintenance therapy for two to three years may decrease the likelihood that the tumors will recur even more than with induction therapy alone. Discuss the possible side effects of BCG therapy, which could include prolonged bladder irritation, with your doctor. If side effects of the BCG become a problem, your doctor may choose to adjust your treatment to try to reduce side effects.