Last Modified: August 21, 2011
Pronounced: bah-sill-uhs kahl-met gey-rahn
Classification: Biologic Response Modifier
Bacillus Calmette-Guerin (BCG) is an inactivated form of the tuberculosis virus. It works against cancer as a biologic response modifier. Biological response modifiers are substances that have no direct antitumor effect, but are able to trigger the immune system to attack tumors. BCG is thought to work by stimulating an immune response and causing inflammation of the bladder wall that, in turn, destroys cancer cells within the bladder.
BCG is given directly into the bladder (intravesically) through a catheter. The urinary catheter is inserted through the urethra (the tube which carries urine from the bladder to the outside the body). The BCG solution is injected into the catheter, which is then clamped off, allowing the medication to remain in the bladder. The catheter may be removed or remain in place for the time the BCG is required to remain in the bladder. The patient is encouraged to roll from side to side and to lie on his/her back to help the medication reach all areas of the bladder. After a predetermined time (usually about 2 hours) the catheter is unclamped, the fluid is drained, and the catheter is removed. Treatments are usually given on a weekly basis, for 6 weeks, followed by treatments once a month, for 6 to 12 months. Your doctor will determine your exact treatment schedule and dose.
Safety Considerations When Receiving BCG:
There are a number of things you can do to manage the side effects of Bacillus Calmette-Guerin. Talk to your doctor or nurse about these recommendations. They can help you decide what will work best for you. These are some of the most common side effects:
Including: Painful or difficult urination, urgency (the need to urinate often), urinating small amounts (frequency), blood in the urine (hematuria), and incontinence.
These symptoms tend to resolve within 48 hours after treatment. If symptoms persist, let your doctor or nurse know.
Fever, chills, muscle aches, and fatigue. Your doctor or nurse can recommend a mild pain reliever, such as acetaminophen or ibuprofen, to relieve these symptoms. These symptoms should also resolve within 48 hours of treatment.
This rare reaction to BCG can occur following exposure to BCG, generally within one week of a biopsy, TUR (trans-urethral resection) surgery, or traumatic bladder catheterization. Symptoms of a BCG reaction include unexplained high fever lasting 24-48 hours or more, chills, confusion, dizziness or lightheadedness (symptoms of low blood pressure) or shortness of breath. BCG reaction can cause pneumonitis (inflammation of the lungs), hepatitis, prostatitis (infection or inflammation of the prostate), epididymal-orchitis (inflammation of the testicles), respiratory distress and other symptoms of sepsis (widespread infection). You should notify your doctor immediately if you experience any of these symptoms.