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 About the Surgery

BCG (Bacillus Calmette-Guerin vaccine for immunotherapy) is NOT chemotherapy, but rather an immunotherapy treatment used in the treatment and recurrence of bladder cancer. Immunotherapy helps your body produce a natural defence against bladder tumour.

How exactly immunotherapies work to destroy cancer and reduce the possibility of recurrence is relatively unknown apart from the known response from the body's immune system.

Intravesical BCG immunotherapy is used for high grade tumours, often in patients with multiple or recurrent tumours. Treatment with intravesical BCG has shown to delay progression to the muscles or/and metastatic disease, preserve the bladder and decrease the possibility of death from bladder cancer.

BCG was originally developed as a vaccine (and continues to be used in some countries as vaccination against tuberculosis). It has since been found to be effective against superficial bladder tumours.

 Aim of Surgery

The intravesical BCG, an inactivated form of the bacterium Mycobacterium tuberculosis, is administered via a urinary catheter directly into the bladder where it remains for two hours. It is thought it stimulates an immune response within the bladder which is successful in reducing the recurrence of bladder cancer, possibly by destroying any remaining cancer cells.

 How Long is Surgery

Each hospital stay is about 4 hours Once per week for 6 weeks

 Anaesthetic

None required

 Incision/Cut

None

 Description of Surgery

A urinary catheter is passed into your bladder and the BCG is instilled via gravity through the catheter into your bladder. The catheter is then clamped and the liquid remains inside your bladder for 2 hours. You will be asked to lie on your front, back and side for 15 minutes each. The bladder is then emptied, via the catheter and the catheter removed.

 Complications of Surgery

Being administered BCG vaccine does not mean you are infected with tuberculosis. There are risks associated with BCG treatment, approximately 1 in 1000 develop significant local reaction and contraction of tuberculosis, a potentially fatal and very infectious disease, develops in fewer than one in a million. Intravesical BCG treatment requires an experienced medical professional to administer the treatment, as patients need to be selected with a particular set of criteria in mind to ensure that they are healthy enough for the vaccine.

Before each treatment, discuss any side effects or problems you may have experienced following the last treatment.

Inform the nurse if you have any of the following:
- feeling sick or have been vomiting
- pain or burning when voiding
- A cough
- Skin rash
- Had tuberculosis (TB) in the past
- Bladder infection
- Operation to remove bladder tumour
- Blood in urine
- Allergies

 Duration of Hospital Stay

Approximately 4 hours