Q1. What is intravesical immunotherapy?
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Q2. What is the goal of this therapy?
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Q3. What medicine is used?
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Q4. When is this treatment started?
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Q5. Do I need to take any special precautions prior to coming to the hospital for the treatment?
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Q6. Are there any precautions to be taken prior to the procedure?
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Q7. What exactly is done?
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Q8. How frequently should I have this treatment?
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Q9. What are the side effects of this treatment?
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Q10. Are there any other special precautions I need to adhere to?
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Q11. Would I, for any reason, need to stop this therapy?
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Q12. How often should I visit my doctor, after completing the course of treatment?
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| Q1. |
What is Intravesical Immunotherapy? |
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A1. |
It is a form of treatment where a specific medicine is introduced into the urinary bladder in patients who are diagnosed with cancer of the urinary bladder. |
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Q2. |
What is the goal of this therapy? |
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A2. |
The goal is to decrease recurrence of the disease, prevent progression, and eradicate residual disease after endoscopic surgery for the cancer. |
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Q3. |
What medicine is used? top |
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A3. |
The medicine most commonly used is BCG (Bacille Calmette-Gučrin). |
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Q4. |
When is this treatment started? |
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A4. |
The treatment is usually started 2 weeks after your initial endoscopic operation. |
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Q5. |
Do I need to take any special precautions prior to coming to the hospital for the treatment? |
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A5. |
Yes, you will need to restrict fluid intake to a minimum for 4 to 6 hours prior to the scheduled time of instillation. |
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Q6. |
Are there any precautions to be taken prior to the procedure? |
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A6. |
Do inform your doctor if you are pregnant, nursing a baby, if you are on any antibiotics, have high fever or have blood in your urine. Also, let your doctor know if you have suffered from tuberculosis in the past. |
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| Q7. |
What exactly is done? |
| A7. |
The BCG is diluted with 60 ml of saline and instilled after inserting a small tube into your bladder.
Prior to the instillation, you are advised to pass urine and empty your bladder completely. After the procedure, you should not pass urine for two hours.
You are advised to sit while urinating for at least a day, in order to avoid splashing urine on your feet. You must also increase your fluid intake after the procedure. |
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Q8. |
How frequently should I have this treatment? top |
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A8. |
This will be decided depending upon the stage of your disease. But generally, you will have one instillation weekly for 6 weeks. Then, after 3 months, you will have one instillation a week for a duration of 3 weeks. After 6 months, you will again have one instillation a week for a duration of 3 weeks.
You may need further instillations every 6 months for the next 3 years. |
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| Q9. |
What are the side effects of this treatment? |
| A9. |
You may experience a burning sensation while you pass urine for a day or two. You may also need to pass urine more frequently. While you pass urine, some blood in the urine may also be expected.
Some patients will have low-grade fever but you are advised to visit your doctor if your fever is higher than 39.5şC or if it persists for more than a day. Your doctor will first determine whether urinary tract infection is present or not. If urinary tract infection is detected, you will be initiated on antibiotics. However, antibiotics like ofloxacin, gentamicin and doxycycline are to be avoided.
Rarely, in less than 1% of the patients, tuberculosis may develop because of this therapy. |
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| Q10. |
Are there any other special precautions I need to adhere to? |
| A10. |
You are advised to abstain from sexual intercourse for 48 hours after every instillation. You are also advised to use a condom at other times – during the 6 weeks course of treatment and for 6 weeks after the treatment has ended. |
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| Q11. |
Would I, for any reason, need to stop this therapy? top |
| A11. |
You may be advised to stop this therapy if you have high fever, a burning sensation while passing urine or if you are passing a lot of blood in urine. |
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| Q12. |
How often should I visit my doctor, after completing the course of treatment? |
| A12. |
Most patients with cancer of the urinary bladder require regular cystoscopic (endoscopic) examination of the bladder.
The schedule is as follows:
- Usually every 3 months for the 1st year
- Every 6 months for the 2nd year
- And yearly thereafter
CHECK CYSTOSCOPY SCHEDULE:
DIAGNOSIS:
STAGE:
DATE OF INITIAL TUR-BT: top
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FIRST YEAR |
DATE |
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3 months |
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6 months |
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9 months |
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12 months |
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SECOND YEAR |
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6 months |
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12 months |
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| ONCE EVERY YEAR THEREAFTER |
SCHEDULE OF INTRAVESICAL
IMMUNOTHERAPY – BCG
DIAGNOSIS:
STAGE:
DATE OF INITIAL TUR-BT:
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6 + 3 CYCLE |
DATE |
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INDUCTION COURSE
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1st Week |
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2nd Week |
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3rd Week |
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4th Week |
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5th Week |
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6th Week |
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MAINTENANCE COURSE
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After 3 Months
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1st Week |
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2nd Week |
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3rd Week |
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After 6 Months
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1st Week |
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2nd Week |
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3rd Week |
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Every 6 Months For 3 Years
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1 |
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2 |
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3 |
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4 |
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5 |
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6 |
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