What is it?

BCG treatment is a medication placed directly into the bladder to reduce the risk of bladder cancer coming back after a bladder tumour has been removed. BCG is a weakened form of a bacteria that stimulates the body’s immune system to destroy any remaining cancer cells in the bladder lining. Treatment is given through a small catheter, usually once a week for several weeks, and does not require surgery or incisions. Ongoing follow-up is important to monitor response and guide any further treatment if needed.

Length of treatment: Approximately 2 hours per visit

Preparation:

• Drink less fluid for 4 hours before your appointment so the BCG stays concentrated in your bladder

• Avoid caffeine and alcohol on the day of treatment

• Tell us if you have a urinary tract infection, fever, or visible blood in your urine - we may need to delay your treatment

• You will be asked to provide a urine sample to confirm there is no active infection

During Treatment:

• A small catheter is used to instill the BCG medication into your bladder

• You will be asked to hold the BCG in your bladder for up to 2 hours, changing position periodically (lying on each side, on your back, on your stomach) so the medication coats the entire bladder lining

• After 2 hours you may urinate normally

Post Treatment - Safety at Home

For 6 hours after your treatment, BCG remains active in your urine. To protect others in your household:

• Sit down to urinate to avoid splashing

• Add about 2 cups of household bleach to the toilet after each void, let it sit for 15 minutes, then flush

• Wash your hands and the genital area thoroughly with soap and water after each void

• Drink extra fluids for the first day to help flush the bladder

Common Side Effects

• Burning with urination, urinary urgency and frequency, and a small amount of blood in the urine for 1-2 days are common and usually mild

• Mild flu-like symptoms (low-grade fever, fatigue, body aches) for 24-48 hours can occur

• Tylenol is preferred for symptom relief

Contact our office if your symptoms last longer than 2-3 days, if you have heavy or persistent blood in your urine, or if your fever is above 38.5°C / 101.3°F or lasts more than 24 hours. If you experience severe pain, shaking chills, difficulty breathing, joint swelling, or any other concerning symptom, seek urgent medical attention through your primary care provider, urgent care, or the ER. Tell any treating physician that you are receiving BCG.