Yes. In fact after removal of superficial bladder cancer (not invasive), the standard of care is BCG injections in the bladder for 6 weeks. It is very effective in reducing recurrence.
Yes. Bcg is intended for use of "superficial" bladder cancer, ie, cancer that has not invaded into the muscle of the bladder (carcinoma in situ, ta or t1 stages). It has been shown to significantly reduce the risk of recurrence and progression vs. No treatment. There is some evidence that BCG may only delay progression--given enough time many people with high risk disease may eventually progress.
Localized immune rea. Ction. If a person is immunized with BCG (a modified tuberculosis organism) re-exposure to BCG induces a local cellular immune response. If BCG is instilled into the bladder of person with bladder cancer, after prior sensitization to bcg, the local cellular immune response may destroy tumor cells.
Immune system based. Bcg is a weakened bacteria in the family of germs that causes tuberculosis. In bladder cancer, it is believed that interactions of BCG and molecules in the cellular structure of the bladder itself induces an immune-mediated response which can cause superficial cancers of the bladder to regress and can delay or prevent recurrence in many cases. It is usually given weekly for 6 weeks to start.
I was diagnosed with bladder cancer in 1980 and one treatment with BCG 1990, since then one tumor and haven't had tumor since 2000. Do I need a cysto?
I'd do it. The altered urothelium in which bladder cancer arises is never really returned to normal. I'm glad you've gotten good results so far.
Maybe. I think you can avoid a cystoscopy if you do not have any symptoms and your urinalysis is normal. Also, I would base it on your original pathology. If it was a low grade tumor you can hold off. You could do a urine cytology, urine sample looking for abnormal cells, to insure there is no evidence of a more aggressive tumor.
No. Treatment with BCG is a form of localized immunotherapy for bladder cancer but it is not chemotherapy. It involves placement of a medicine into the bladder that helps one's own immune system fight the cancer.
No. Bcg is a topical therapy that is essentially a type of immune based therapy applied only to bladder cells. Traditional chemotherapy is given intravenously and thus all body cells are exposed. Some chemotherapy drugs can be given topically like BCG and probably exert their effect via typical cancer cell-killing compared to immune stimulating effects of BCG similarly administered.
For a 70-year-old man who was recently diagnosed with bladder cancer, is BCG a reasonable 1st treatment?
Maybe. Bcg is a first good step but depends on the biopsy specimen. Bcg is standard treatment for certain types of bladder cancer and if the patient meets those criteria, then it is a good first step. It is not necessarily dependent on age.
Depends. Bladder cancer should first be removed as much as possible through a scope placed through the penis and urethra into the bladder. For small tumors that have not grown into the muscle, either bcg or chemotherapy placed directly in the bladder is usually recommended to try to kill any remaining microscopic cells and minimize the risk of recurrence. More advanced tumors need different treatment.
See below. Intravesical BCG used to both treat and prevent recurrence of urothelial bladder cancer. Despite its widespread common usage, its specific mechanism of action poorly understood. BCG is an attenuated form of the bacteria that causes TB (much like a vaccine) that "stimulates" (not weakens) ones immune system in such a way to kill the tumor cells. Pts with weak immune systems have poorer responses.
I failed interferon treatment and BCG treatment for bladder cancer. Is surgery the only option left?
Probably best option. If you have failed tretament with BCG and interferon, some patients may reposnd to treatment with valstar (valrubicin). However, depending on the specifics of your bladder cancer, cystectomy and urinary diversion may be your best option. You should discuss this with your urologist.
Not as easy to answe. Some people have tried other intravesical therapies like Mitomycin or valstar (valrubicin) that now is indicated for BCG failure. The problem is it is important to know how many and time between recurrences and how much involvement in your bladder. Multifocal recurrent disease is not a good prognosis and you should not wait since bladder cancer will progress. If you are healthy, you should consider cystectomy.
Yes. Ask your doctor, of course, since your particular circumstance may differ...but intravesicular (in the bladder) BCG treatment for superficial bladder cancer does not make shingles vaccine dangerous or ineffective. Your age and medical history put you at enough risk of shingles that a vaccination is beneficial.