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BCG immunotherapy

General

Intravesical bladder immunotherapy with BCG (Bacillus Calmette-G uerin) is performed on all patients at a high risk for recurrence after a transurethral resection of the bladder (TUR-B). Upon instillation of BCG in the bladder, the bladder will start to produce antibodies, which will attack the cancer cells. 

  • Induction cycle: one instillation per week for 6 weeks
  • Maintenance/follow-up cycle: one instillation per week for 3 weeks  

Up to 50% of those who do not respond to the induction cycle will respond to a repeated induction cycle. Repetition of maintenance cycles for up to three years should be considered based on tumor risk and tolerability. In general, patients with high-risk tumors (Tis, T1G3) receive a full maintenance cycle. The procedure is performed on an outpatient basis. At the Norwegian Radium Hospital, when and how often the maintenance cycle is carried out is determined on an individual basis.

Indications

  • Three episodes of tumor recurrence within 18 months
  • Primary T1G2/3
  • Primary Tis, or possibly concomitant Tis in multiple localizations 
  • Multiple recurrences at the first or second follow-up after TUR-B, especially if there was primary multiplicity, or the primary tumor was large (³ 3 cm)

Goal

Treatment for superficial transitional epithelial cancer in the bladder (Ta, T1).

  • Reduce the chance of recurrence.
  • Prevent progrediation of the disease.

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