Intravesical (bladder) immunotherapy, also called biological therapy, may be used in some cases of superficial bladder cancer. This treatment causes the body's own natural defences (immune system) to attack the cancer whilst chemotherapy of bladder is used to enhance the immune system's ability to fight disease. In the case of bladder cancer, when intravesical immunotherapy is performed, a liquid containing the vaccine derived from the bacteria that causes tuberculosis (BCG) is used to fight the malignant cells.
Intravesical immunotherapy involves infusing liquid BCG via a catheter into the bladder. It is infused through the urethra into the bladder, usually once a week for 6 weeks . Instillation of BCG triggers a strong immune defence attack in the bladder which destroys not only the BCG bacteria but the cancer cells as well. Sometimes BCG is used with other immune stimulating drugs such as interferon.
Who receives this treatment: It is used to treat superficial (early stage) cancers, particularly those which have relapsed following initial resection. Immunotherapy is not used in patients with gross blood in their urine (haematuria).
What to expect: The treatment is usually given on an outpatient basis.. The drugs are infused directly into the bladder via the catheter which is clamped to stop the liquid pouring out for between 20-40 minutes. During this time the patient is asked to change positions in order to spread the liquid around the bladder. After this time the liquid and catheter is removed and disposed of safely. This is often repeated weekly for between 6-8 weeks depending on the recommendations form the surgeon.
Side effects: These can range form very mild to severe. If severe it may not be possible to administer the full course. Most of these side effects occur immediately after the procedure for a day or two - if they persist patients are advised to go to their doctor/ nurse to have their urine tested for infection. Also if a high fever occurs (over 101.5°F) this may indicate that the bacteria have entered the bloodstream (called bacteremia). This condition is serious and requires antibiotic treatment. Prompt medical care should be sought.
Possible side effects include:
As in all cancer treatments, these unpleasant side effects vary widely with the individual. Drink plenty of liquids particularly water, simple analgesia such as paracetamol and anti-inflammatory drugs. If symptoms do not settle within a few days take a urinary sample to the GP or specialist nurses to ensure that a urinary infection has not developed.
Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.