BCG Bladder Instillation. An information guide

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1 TO PROVIDE THE VERY BEST CARE FOR EACH PATIENT ON EVERY OCCASION BCG Bladder Instillation An information guide

2 BCG Bladder Instillation After reading this leaflet we hope you and your family will have a greater understanding about intra-vesical immunotherapy as a treatment for bladder cancer. If you have any questions please feel free to ask a nurse to explain further at any time. BCG (Bacillus Calmette Guerin) This is a drug used in the treatment of bladder cancer. It works by bathing the inside wall of the bladder and producing a chemical cystitis. This is a type of inflammation, which slows down the regrowth of abnormal cells in the bladder wall. Why do I need this treatment? You have recently been investigated for bladder problems and you have been found to have some abnormal cells in your bladder. Your body is made up of tiny building blocks called cells. Under normal circumstances these cells are reproduced to replace dead cells, and repair damage to others in a controlled way. Sometimes these cells can carry on reproducing. More cells are made than what die, consequently a lump can develop. This lump is called a tumour. Tumours can be classified as benign or malignant. Benign tumours will not normally cause too much trouble. However, malignant (cancerous) tumours will continue to grow and can destroy surrounding tissues if they are not treated. 2

3 You have a tumour/tumours which are referred to as bladder cancer. Tumours sit on the inner most lining of the bladder and if left untreated may affect other layers of the bladder wall. Will other drugs interfere with the treatment? Drugs and therapy, including radiation, which suppresses your immune system, can interfere with how well your bladder tumours respond to treatment and may increase the risk of bone and other infections. Therefore it is essential that you inform us of all drugs and/or therapy you are receiving before starting treatment. What are the alternatives? There are no alternatives to this treatment. If this treatment is not given, you are putting yourself at risk of the bladder cancer spreading in your bladder and through the bladder wall. What are the benefits? Having this treatment will reduce the risk of recurrence of the disease and the chances of it spreading. Before the treatment Please do not have anything to drink for 2-3 hours before the procedure. This is to ensure the drug is not weakened and remains in your bladder for the prescribed time. 3

4 How is the treatment given? you will be asked to attend for your treatment weekly for 6 weeks. It is very important that the treatment is continuous, so if you cannot attend for any reason please let us know immediately on arrival you will be asked to pass urine. Then you will be taken into a private area and asked to remove all clothing from the waist down and lie down on a couch a catheter (a very fine tube) will be inserted into your bladder to drain any remaining urine from your bladder the immunotherapy is given via the catheter directly into the bladder. The catheter is then removed you will be asked not to pass urine for 1 2 hours in order to keep the solution in contact with your bladder for the necessary period of time after the first instillation you may go home with the drug and pass urine at home moving around during this time is encouraged when going to the toilet, urinate carefully into the toilet bowl. Men should sit rather than stand. Then put a bleach solution into the toilet bowl and close the toilet lid. Leave for 15 minutes then flush the toilet 4

5 repeat this every time you go to the toilet for 24 hours after the bladder instillation. What are the side effects? The majority of patients have no or few side effects from this drug. The most common are: frequency on passing urine discomfort on passing urine blood in the urine urinary tract infection. These side effects are not unusual and should not cause you undue concern. If you are experiencing any of them, try to increase the amount of fluid you are drinking. However, you may want to reduce this again after 7pm so as not to disturb your sleep. Some patients do complain of increased tiredness and the usual advice is to rest. Once the treatment is completed/stopped all side effects settle down. 5

6 Other rare side effects are: high temperature shivering shaking sweating feeling extremely tired joint pain feeling sick or vomiting cough skin rash. These side effects are rare but if you do get them please contact your Urology Specialist Nurse or GP. 6

7 Following the treatment You will be sent an appointment within 8-12 weeks after completion of your treatment. Your doctor may check your bladder with a telescope (Cystoscopy). You may require further maintenance treatment that is given every 3 months initially with 3 weekly instillations for up to 3 years. Frequently asked questions Can I have a normal sex life whilst having this treatment? Yes, but we do advise that condoms are used Will my hair fall out/feel sick/lose/increase weight? No. We only expect the side effects mentioned above. Any further questions? Then contact the relevant urology nurse specialists at your hospital. Please ring the relevant hospital and asked to be put through. 7

8 If English is not your frst language and you need help, please contact the Ethnic Health Team on Jeżeli angielski nie jest twoim pierwszym językiem i potrzebujesz pomocy proszę skontaktować się z załogą Ethnic Health pod numerem telefonu For general enquiries please contact the Patient Advice and Liaison Service (PALS) on For enquiries regarding clinic appointments, clinical care and treatment please contact and the Switchboard Operator will put you through to the correct department / service Date of publication: November 2006 Date of review: February 2016 Date of next review: February 2019 Ref: PI_SU_284 The Pennine Acute Hospitals NHS Trust Wood pulp sourced from sustainable forests