Banner Image: Dr. Neal Shore, a member of BCAN’s Scientific Advisory Board, speaks with a patient.
Certain types of bladder tumors are hard to remove using surgical procedures like a TURBT, particularly flat tumors (carcinoma in situ). In addition, some tumors may be likely to recur after initial resection. In these cases, special medications that destroy cancer cells may be placed directly into the bladder. This treatment is called intravesical therapy.
There are two principal drugs that are used as intravesical chemotherapy or immunotherapy:
Bacille Calmette-Guerin or BCG
An intravesical immunotherapy that causes an immune or allergic reaction that has been shown to kill cancer cells on the lining of the bladder. BCG is often preferred for patients who have high-grade tumors or who have CIS or T1 disease.The urologist may also suggest maintenance therapy using BCG. The rationale for maintenance therapy is that the initial therapy plus intermittent therapy for 2 to 3 years may provide a decreased likelihood that the tumors will recur. The disadvantage to maintenance therapy is prolonged bladder irritation, fever, and bleeding which may force the doctor to decrease the BCG dosage or to discontinue the therapy. Both Mitomycin C and BCG are administered through a catheter which is placed in the bladder through the urethra. The drug is then introduced into the bladder.
An intravesical, anti-cancer drug that has been shown to be effective after the TURBT in reducing the number of recurrences of bladder tumors by as much as 50%. An advantage of Mitomycin C is that it is not easily absorbed through the lining of the bladder and into the blood and, thus, less risky than chemotherapy given intravenously. Side effects from the drug can be pain when urinating and/or “chemical cystitis”, an irritation of the lining of the bladder which can feel like a urinary tract infection. Both these side effects are temporary and will disappear when the therapy is stopped. This drug may be delivered into the bladder immediately after TURBT. For more information, see the video above about TURBT and intravesical chemotherapy.
For some patients, Valrubicin may be used. The drug is indicated for patients whose CIS bladder cancer did not respond to BCG treatment or and who cannot have surgery right away to take out the bladder.
Click here to read our Get the Facts | BCG (PDF), filled with advice from patients who have experienced it. For a more in-depth look at BCG, check out our Expert Explanation | Intravesical Therapy with BCG, an expert explanation by Dr. Janet Kukreja and Dr. Ashish Kamat from MD Anderson Cancer Center.
Smart phones and tablet apps can help you better understand your bladder cancer diagnosis and treatment options. BCG Treatment—a new patient teaching app from the Roswell Park Cancer Institute ATLAS Program is now available free of charge for Apple and Google products. Use your devices to help you better understand BCG (i.e., Bacillus Calmette-Gue´rin) treatment. Learn about the benefits and ways to reduce or manage the potential risks.
Information and services provided by the Bladder Cancer Advocacy Network (BCAN) are for informational purposes only. The information and services are not intended to be substitutes for professional medical advice, diagnosis or treatment. If you are ill, or suspect that you are ill, seek professional medical attention immediately! BCAN does not recommend or endorse any specific physicians, treatments, procedures or products even though they may be mentioned on this site.