Bacillus Calmette-Guérin (BCG) is a live vaccine, which is given to treat bladder cancer and helps prevent the cancer from recurring. When it is put into your bladder it causes inflammation. This inflammation destroys tumors and cancerous cells, therefore helping to stop the cancer from growing and spreading. You should not have BCG treatment if you have any of the following:
- If your Trans Urethral Resection of Bladder Tumor (TURBT) was done less than 2 weeks ago
- You should not receive a ‘live’ vaccine for 4 weeks before or after receiving a dose of BCG.
- If you are immune-suppressed because of medication you are taking
- Have an active urinary tract infection (UTI)
After your bladder biopsy confirms bladder cancer the usual course of treatment is once a week for 6 weeks. BCG instillation is done by inserting a catheter through the opening of the urethra into the bladder (see below). When the catheter is in the bladder, medication (BCG) will be passed through the catheter into the bladder.
What preparation is involved prior to BCG treatment?
1. You should limit what you drink (one hot drink/one glass of water) for at least four hours before treatment. By reducing your fluid intake it will help to increase the concentration of BCG in the bladder and allow you to keep the BCG in the bladder for the necessary amount of time
2. If you normally take diuretics (water tablets), take them after your BCG instillation is completed rather than first thing in the morning. This will help in reducing your fluid intake.
3. Please inform your urologist if you have felt feverish, tired, or had chills since your last treatment or if you have been urinating frequently.
How long will the treatment take?
The actual bladder installation time takes only 15 minutes and you will be able to go home after it is instilled, but you will need to keep the BCG in the bladder for two hours before voiding.
What happens during instillation?
1. You will be asked to urinate so your bladder is empty.
2. A catheter will be passed into the bladder through the urethra. BCG medication will be instilled through the catheter into the bladder. This is known as bladder instillation.
3. The catheter will be removed from the bladder after the instillation is completed.
4. It is extremely important you go home after your bladder is instilled with BCG. You must continue certain tasks after you leave the office.
What happens after the instillation (at home)?
1. BCG medication must be in your bladder for two hours after it is instilled.
2. To be sure the medication coats your entire bladder when you get home, please position your body from side-to-side and back to front. Do this every 15 minutes until the two hour time is up.
3. After the medication has been in your bladder for two hours, sit down on the toilet to urinate and fully empty your bladder.
4. After urinating, pour two (2) cups of household bleach into the toilet.
5. Wash your hands and genital areas thoroughly after you urinate.
6. Repeat steps 3-5 for 6 hours after each treatment.
7. Drink plenty of fluids after your instillation to flush your bladder.
Until your next instillation
You may experience some burning when urinating for the first time after your treatment. If this occurs, you need to increase your fluid intake.
If you experience continued pain, burning on urination or any of the following please call our office immediately.
- Urinate frequently
- Bright red blood or blood clots in the urine
- Joint pain
- Skin rash
- Have a feeling of discomfort
- Increased fatigue
- Flu-like symptoms