BCG immunotherapy in bladder tumours
Intravesical BCG has been used to treat bladder cancer since the late 1970's. Given once a week for 6-12 weeks, it destroys carcinoma in situ and superficial tumours, and causes measurable changes in the immune system.
The main problem with intravesical BCG is it's side-effects:
- systemic "BCG-osis" with lung granulomas, disturbed liver function, fever and malaise; requires prompt anti-tuberculous chemotherapy as may be fatal
- chemical cystitis
- flu-like symptoms
Consequently, BCG is usually reserved for:
- carcinoma in situ
- high grade superficial tumours i.e. pT1G3
- pTa and pT1 tumours that have failed to respond to other treatments
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