BCG Treatments — Bladder Cancer Awareness Month
Standard Care Treatment for Non-Muscle Invasive Bladder Cancer
I was diagnosed with non-muscle invasive bladder cancer, and after my TURBT and the pathology report, it was classifed as a Ta high grade disease. Thus, my doctor suggested that I should follow up with the standard recommendation of BCG (Bacillus Calmette-Guérin) as treatment, in my case post-surgery, after the removal of the two tumours.
BCG (explanation directly from Bladder Cancer Canada site)
Once the bladder has healed from your diagnostic TURBT, a second TURBT may be performed within about six weeks if the tumour was aggressive. A drug called BCG (Bacillus Calmette-Guérin) may be inserted into your bladder through a catheter once a week for about six weeks (intravesical therapy).
BCG is a weakened form of the tuberculosis mycobacterium which stimulates immune responses within the bladder to destroy the cancer cells.
You’ll hold the BCG inside your bladder for up to two hours. Medical facilities have different treatment protocols, but you may be asked to spend time lying down and perhaps rolling on each side and front and back to ensure the chemical makes contact with the full bladder lining.
Maintenance treatments of BCG may be prescribed to reduce the risk of the tumour recurring. This often involves a three-week treatment plan every three to six months for up to three years.
The initial treatments usually produce few, if any, side effects. Still, as the treatments progress, you may experience burning when urinating, a sense of urgency to urinate or the need to urinate more frequently. Some people report fatigue and a mild fever, achiness and nausea. There can be severe reactions, such as pain, inflammation and bleeding, but these are not the norm and diluted or reduced amounts of BCG can be given to help combat these side effects.
The Treatment Process
At Sunnybrook Health Science Centre, urology department, I visited the cystoscopy suite for my course of treatments. The first cycle was six treatments over six weeks beginning in May of 2014, with a break, and then three weeks of treatments, with breaks up to December 2015. I would try to get in for the earliest appointment in the morning. The procedure involves dropping your drawers and then covering yourself up. The nurse will prep the area, provide some freezing gel for the urethra, insert the catheter and then put the BCG up into the bladder. It takes a matter of minutes. You then expected to return home, go about your day or lay down and “baste”.
After two hours, you can start to “drink like a fish (as Nurse Zara at Sunnybrook suggested) and then pee the stuff out. My ritual was always going home and making a big pot of Lipton’s Chicken Noodle soup, followed by glasses of water all day — with intermittent pee sessions — until everything was running clear by the evening. There was some burning session, but nothing too severe. On the day of the BCG installation, I felt pretty drained, groggy, and just worn down. However, awakening the following day, I felt a renewed feeling of energy and was back feeling top-notch. In the last few installations of BCG, I would see blood when I was voiding. This was surprising to me because it was the only time that I had seen blood in the urine. All said and done, after 18 installations (6–3–3–3–3) I was complete. After 18 installations, Dr. Kodama suggested that I call it “complete”. Touch wood — I’ve not had to return for any more BCG treatments.
Check-ups…
I did return for Cystoscopies after BCG treatments on a regular 3-month interval, that then got extended to six months, and now I have been on an annual visit in November for annual check-ups. So far, so good. Love to hear those words — “All Clear for another year, see you in twelve months”.
Note
As I have stated in previous blog posts on my bladder cancer journey, this is my own experience. I know from speaking with other patients that some had other experiences. Some folks find the cystoscopies uncomfortable or the BCG treatments intolerable. I just found that with each procedure, the most crucial factor is to attempt to relax. If you can be as calm as possible and not tense up muscles, you will have a fairly pain-free experience. The other critical factor was to drink plenty of water — like a fish! (Thanks Zara) I always remarked that it is incredible what you get used to along the journey to beat bladder cancer!
