BCG Treatments for Bladder Cancer

BCG therapy is an immunotherapy that uses a weakened form of the bacterium Mycobacterium bovis to stimulate the immune system. When instilled into the bladder, it triggers an immune response that targets and destroys bladder cancer cells. This localized activation not only attacks existing cancer but also helps prevent new tumors from developing.

BCG is typically given once a week for six consecutive weeks. This induction course is designed to build a strong, sustained immune response in the bladder lining. Studies have shown that this approach significantly decreases the risk of cancer recurrence and slows or prevents progression to more invasive disease. Depending on your case, maintenance treatments may follow to extend protection.

• Limit fluid intake for 4 hours before your appointment to improve medication contact time.
• Tell your care team if you have fever, urinary symptoms, or blood in your urine.
• Discuss any medications, supplements, or immune-related conditions with your provider.

• Empty your bladder before treatment begins.
• A catheter is inserted to deliver the BCG solution directly into your bladder.
• The solution is held for about 2 hours, with position changes every 15 minutes to ensure full bladder lining exposure.

• Drink extra fluids for the next 24 hours to help flush out any remaining medication.
• For 6 hours after, urinate while sitting and add bleach to the toilet to neutralize bacteria.
• Mild burning and urgency may occur for 1–2 days; call your provider for high fever, chills, or persistent discomfort.

While BCG therapy is generally safe, rare complications can occur. These include severe bladder inflammation, systemic BCG infection, or joint pain. Immediate medical attention is needed for symptoms such as persistent high fever, shortness of breath, jaundice, or rash. Your provider will discuss your risk factors before starting therapy and monitor you closely during treatment.

With decades of proven results, BCG therapy remains the gold standard for treating non–muscle invasive bladder cancer. Its ability to reduce recurrence and progression means many patients avoid more invasive treatments. Commitment to the full course and follow-up cystoscopies is essential for the best outcomes.