Bacillus Calmette-Guérin (buh-SIH-lus KAL-met-gay-RIN) therapy is a type of immunotherapy that treats bladder tumors. It’s the most common kind of intravesical immunotherapy used to treat early-stage bladder cancer. Intravesical (IN-truh-VEH-sih-kul) is when the drugs go right into your bladder through a tube placed in your urethra.

What is BCG treatment?

The BCG in this drug is inactivated tuberculosis (TB) bacteria made from a type of Mycobacterium bovis. This is a liquid drug that goes into your bladder through a catheter (small tube) placed in your urethra. BCG triggers an inflammatory response in your bladder that stops the tumor from coming back.

Is BCG treatment a kind of chemotherapy?

This treatment is a type of immunotherapy, not chemotherapy. What they have in common is that the use drugs that go right into your bladder. But they are different treatments that use different drugs.

MSK offers BCG treatment is an alternative to chemotherapy for high grade non-muscle invasive bladder cancer (NMIBC). People often come to MSK for BCG treatment after their healthcare provider offered chemotherapy as the only treatment option.

When is BCG treatment recommended?

BCG is for:

• Early-stage bladder cancer. This is cancer that is only in the bladder’s lining, and is stage 0 or stage 1.
• Bladder cancer that is not in the muscle of the bladder’s wall (non-muscle invasive bladder cancer).
• People at high risk for non-muscle-invasive bladder cancer coming back after transurethral resection of bladder tumor (TURBT). It kills any cancer cells that remain right after your TURBT procedure.

How is BCG treatment done?

This liquid drug is given through a catheter into the bladder. You will get this treatment once a week, for 6 weeks. You will get inactivated tuberculosis (TB) bacteria through a catheter (small tube) placed in your urethra.

You will need to try to keep this drug in your bladder for up to 2 hours. BCG leaves your body when you urinate.

Side effects of BCG therapy include:

• Bladder irritation. It may start a few hours after treatment and can last for 1 to 3 days.
• A feeling you need to urinate (pee) more often, or right away.
• Burning or pain when urinating.
• Chills, flu-like signs, mild fever, tiredness, or weakness.
• Upset stomach.
• Less appetite.

What happens if BCG does not work?

Some early-stage bladder cancers don’t respond to BCG therapy. If bladder cancer returns, we may recommend other drugs, including chemotherapy drugs. They also are given through your urethra. You will have follow-up visits every few months after your therapy ends. We will monitor you to be sure your bladder is healthy, with no sign of cancer.