bladder cancer
BCG (Bacillus Calmette-Guerin)PATIENT INFORMATION AND INSTRUCTIONS
TB/KZ 1/10/08
WHAT IS BCG?
BCG (Bacillus Calmette-Guerin) is a weakened bacteria first created as a vaccine for tuberculosis. Although BCG is
ineffective as a vaccine, it can stimulate your immune system and help your body fight your bladder cancer. There
are several reasons your doctor may choose to give you BCG. BCG is used to decrease the chance of having
another bladder tumor, prevent the cancer from invading the muscle wall of the bladder, and to cure carcinoma-insitu.
Your surgeon can help you understand the reason BCG is appropriate in your case.
HOW IS BCG GIVEN?
The standard initial course is one treatment per week for six weeks. The dosage and duration of your treatment may
be different as determined by your doctor. BCG must be given carefully in a doctor’s office or hospital. BCG is a
weakened – not dead – bacteria. It is important that we minimize any exposure for others who are not receiving this
treatment. A bladder catheter is placed each week to put the BCG in the bladder. You will hold the BCG in your
bladder for two hours. You must be very careful about where, when, and how you empty your bladder after getting
the BCG (instructions below). You will see your urologist 4-12 weeks after getting the BCG to determine if any other
treatment is necessary.
WHAT ARE THE SIDE EFFECTS OF BCG AND WHAT DO I DO ABOUT THEM?
- Burning and Frequency with urination: increase your fluid intake. Avoid caffeine and alcohol. Burning and frequency may get worse during the treatment. Sometimes medications can help with these symptoms.
- Low-grade fevers (up to 100F), fatigue, aching, and flu-like symptoms: Tylenol will help to relieve these symptoms within 48 hours. Drink as much fluid as you can to keep the urine clear. Rest. These symptoms occur because the BCG stimulates your immune system.
- Blood in the urine: The BCG causes some irritation to the bladder and may cause bleeding that can turn your urine red. Drink as much fluid as you can to keep your urine clear and to prevent blood clots from forming in the bladder. Bleeding most often resolves.
- If you have a fever over 101º, chills, rash, prolonged cough, specific joint pain, or if any of the above symptoms last longer than 48 hours, you need to contact Metro Urology as soon as possible. More severe symptoms often indicate a serious reaction to the BCG and may require medication to treat.
WHAT HAPPENS ON THE DAY I GET BCG?
- At each visit for the BCG treatment you will be asked to leave a urine sample. If you have a bladder infection or a large amount of blood in the urine you should not receive BCG that day.
- A catheter will then be placed into your bladder to empty any residual urine and instill the BCG. The person giving you the BCG must be very careful not to spill any BCG. Please work with your caretakers to ensure proper delivery of the BCG.
- You will be allowed to leave immediately after the treatment.
- The BCG should remain in your bladder for two hours for best results. If you must urinate before two hours, please let us know at your next visit as to how long you were able to hold the BCG.
- Urinate after two hours of holding the BCG. Men should SIT on the toilet to urinate so that the BCG does not splash. Completely empty your bladder. DO NOT FLUSH THE TOILET AT THIS POINT.
- Wash your hands and genital area with soap and water after urinating.
- After urinating and washing your skin, pour two cups of bleach (Clorox or equivalent) into the toilet. Let the bleach and BCG mixture stay in the toilet for 15-20 minutes before flushing. Flush the toilet. (Remember: BCG is a weakened –not dead – bacteria. It is important to kill the bacteria so it won’t affect others.)
- Repeat steps 5-7 each time you urinate for the next six hours. You should plan to stay home and use the same toilet for those six hours. Drink at least 8 oz of liquid every hour for those six hours to help flush the bladder well.
ARE THERE OTHER THINGS I SHOULD KNOW? WHAT ABOUT SEX?
Do not have sexual intercourse for at least 48 hours after each BCG instillation. Men need to wear a condom the entire course of the six-week treatment and for six additional weeks after treatment has ended. Women should avoid vaginal contact for one week following each treatment and for six additional weeks after treatment has ended. (Remember: BCG is a weakened –not dead – bacteria that could affect others.)
Your doctor will want you to have a Chest X-ray and a tuberculosis skin test (PPD) before starting the treatment. Your PPD will most likely become positive after the treatment and the fact you had BCG should be mentioned if you have other PPD skin tests in the future.
Contact Metro Urology at the location in which you received the BCG treatment if you have concerns.
Bladder Cancer Centers
St. Paul – Fort Road Medical Building 651-999-6800
Coon Rapids – Parent Prof. Building 763-783-8582
Maplewood – Maplewood Prof Bldg 651-999-6896
Fridley – Unity Prof. Building 763-783-8582
Woodbury – Cornerstone Building 651-999-6938
Plymouth – West Health Campus 763-383-8870