When given intravesically, your body absorbs little or none of the drug, making systemic reactions rare. Allergic reactions can occur in 3% to 19% of patients. Rarely, some patients will experience decreased blood cell counts. Also, some researchers have reported a decreased bladder capacity (the volume of urine a bladder can hold). The most common [...]

The efficacy of mitomycin C, as with all intravesical therapies, depends on when and how it is given, as well as to whom it is given. Mitomycin C was initially given to patients who failed to respond adequately to BCG. Many of these patients did respond to mitomycin C, thus delaying or preventing the need [...]

Mitomycin C is a form of chemotherapy that is given intravesically in the same way that BCG is given. This type of chemotherapy acts by binding to tumor cell DNA, causing the DNA to malfunction or break apart. Without functional DNA, the tumor cells rapidly die.

Interferons are chemicals that are part of your body’s normal immune system. There are several subtypes of interferons, including α-interferon. BCG is, at least in part, effective against bladder cancer because it causes an increase of  α-interferon in the bladder, which in turn helps to kill cancer cells. Interferon can be pre-pared and concentrated in [...]

BCG is administered through a catheter. The nurse will ask you to urinate to empty your bladder completely. A urine dipstick test will be performed to test for blood or infection. If the dipstick test is negative, then the BCG will be instilled into your bladder through the catheter. Once the solution is in your [...]

BCG therapy is well tolerated by the majority of patients who receive it. It is, however, a live bacteria, and thus has a small potential of causing infection. Approximately 75% of the patients do complain of frequency and urgency immediately after the treatment, although this usually resolves quickly. Approximately 10% of people complain of some [...]

BCG can best be described as very effective at preventing and delaying recurrences. Its actual effect depends on the grade and stage of tumor being treated as well as the dose and timing of the treatments. Most urologists will give weekly instillations of BCG for 6 weeks. Cystoscopy is then performed 6 weeks after the [...]

BCG is an option for treatment only after the initial TURBT has been performed and the pathologist has established a definitive diagnosis. Patients with low-grade, low-stage tumors are usually not given BCG. These patients have periodic cystoscopies performed to screen for tumor recurrence. If the tumor does recur in these patients, they are almost always [...]

BCG stands for Bacillus Calmette-Guerin. It was developed in the 1920s. Some readers may recognize this as a vaccine for tuberculosis, as it is still used for this purpose in many countries. BCG is a live, attenuated (weakened) form of the bacteria that causes tuberculosis. Although it is too weak to cause tuberculosis, it does [...]

Once you have been diagnosed with invasive bladder cancer, it is very important to seek treatment right away. The goal of bladder cancer treatment is to stop the cancer before it spreads outside of the bladder. Surgery can cure only when all of the cancer is removed. If the tumor has spread outside of the [...]

Immunotherapy takes advantage of the methods used by our own immune system to attack cancer cells. There are two types of immunotherapy: passive or active. Passive immunotherapy involves the direct administration by doctors of molecules or cells to a patient and requires no involvement by the patient’s own immune system. Active immunotherapy attempts to activate [...]

Intravesical therapy is said to be therapeutic when it is used to kill visible tumor cells. Some patients are unable to have their entire tumor(s) removed with TURBT because of the location or extent of the tumor. Intravesical therapy in these patients is designed to kill the remaining tumor and is thus called therapeutic. Intravesical [...]

Intravesical therapy is treatment for bladder cancer that is applied directly into the bladder. It can be either immunotherapy or chemotherapy. The most common type of immunotherapy is BCG. BCG is immunotherapy that may be given with or without interferon. Several chemotherapeutic agents are also available, including mitomycin C, thiotepa, doxorubicin, epirubicin, valrubicin, and others. [...]

Most alternative therapies have not been well studied, making it difficult to recommend any specific therapy. Supplements like bovine and shark cartilage are often touted as being active against cancer, but no good studies have yet been completed that show a convincing effect. Herbal remedies are also available, although none have been proven to be [...]

The best course of treatment for urachal carcinoma is not clear because it is such an uncommon tumor. Patients with metastases are treated primarily with chemotherapy. Patients without metastases usually are treated with a partial cystectomy that includes removal of the tumor and bladder adjacent to the tumor along with the urachal ligament, including the [...]

The treatment of choice currently for carcinoma in situ is intravesical therapy with BCG. Carcinoma in situ in most cases is not adequately treated by resection alone because it tends to be located diffusely throughout the bladder. Sixty to 70% of patients with carcinoma in situ will respond to a standard course of BCG. Although [...]

Superficial bladder cancer is a recurrent and potentially progressive disease. Most studies have shown that patients with a higher stage and/or grade have recurrences more frequently than do patients with a lower stage or grade. Approximately half of the lowest stage and grade tumors (Ta, Grade I/II) will recur, most of them in the first [...]

PDT is a new treatment that is still evolving. It is currently given only to patients with recurrent tumors who have failed BCG treatment. Newer sensitizing agents have improved its efficacy. In one study, 84% of patients with BCG-resistant papillary tumor had a complete response, and 75% of patients with carcinoma in situ had a [...]

Photodynamic therapy (PDT) is a cancer treatment that uses a drug and a certain type of laser light to kill cancer cells. A drug that is not active until it is exposed to the light is injected into a vein. The drug is picked up preferentially by the cancer cells, as opposed to normal cells. [...]

This question still creates some controversy. Based on the results of the studies, most experts recommend giving perioperative chemotherapy to almost everyone at the time of TURBT, unless the bladder is perforated during the surgery. The  efficacy of all of the different agents seems about the same. A  meta-analysis (a composite review of a number [...]