BCG treatments for my Dad??, 86yo, frail and bed bound

Karen,
I am sorry to hear of your fathers situation, my father had open heart at the age of 86, he had every complication possible only to die 5 months later with all the scars of his operation. He fought a staff infection, blood clots, c-dif, now I wish he would have listened to us and just went on blood thinners or something less invasive as before all this he at least was mobile, lucid, and a whole human being. My advice is don't give him anything that will make him worse, if he is happy with his life as it is....let him live without any interuption from more medical intervention. That was my experience. Bless you and your family in this holiday season. Ginger Beane

rosemary,

thank you so much for "jumping in". I appreciate all feedback and help. You have all been wonderful and a great resource. I did ask Dr Lamm my question. I'll keep
you updated. Thank you.
karen

Karen,

I know that you addressed your question to Wendy, but meanwhile, I hope you don't mind me jumping in with my opinion again...

Having gone through BCG myself, I can't help but feel a little emotional about the idea of inflicting this possibly harsh treatment on your father, not to mention the hardship on your Mother, when it might not be of benefit. I like the idea of having faith in our doctors, but in this instance, I really think you might want a second opinion...

I personally had a strong and radical response to BCG. At the very least, your father will probably suffer the discomfort of extreme burning on urination (like voiding razor blades) and possibly mild, flu like symptoms.

I tried getting a definitive answer from the FAQ section of Dr. Lamms' website.
The search result that I got does not fit your father's situation exactly, but it does support Wendy's information concerning effectiveness of BCG treatments in patients over the age of 80.

If you E Mail Dr. Lamm with a question about this, he will reply. He is very kind and an expert in the field of Bladder Cancer and BCG treatments.

My dad, 86 years old and in good health, was diagnosed two weeks ago with bladder cancer, stage T2a. What treatment options are available for my dad, keeping in mind his age and good physical conditions? Thanks

Age certainly does become a major consideration when selecting treatment for someone aged 86..... Unfortunately, BCG has been recently found to be much less effective in patients over the age of 80 ...

Here is Dr. Lamm's website opened to the page where you may pose your question...

www.bcgoncology.com/drlamm/askdrlamm.html

Best regards,
Rosemary

:-\ Hi Wendy,

Thanks for all the good info. I found the research on patients over 80 and BCG treatments. Was O'Donnell also the researcher behind the bcg not being the first line treatment for papillary tcc? I'm having trouble locating that article. I have more information on my fathers pathology report. It is staged as TaG1 papillary tcc, although it is his second recurrence ( and this time with multiple sites vs one site the first time)His operative report reads that there were multiple tumors to or blocking the bladder neck. Others were on the dome base lateral walls bilaterally. The largest tumor was greater than 4cm, which I understand is quite large. He went 14 months between cystos and turbt because of logistical and transport issues. My mother is not in favor of the BCG treatments. We had a good year in between turbt's and if we could get that much again it would be great. He is so frail and fragile. I'm just trying to gather up all the information I can. The uro will be pushing for the BCG. In his mind, it's a no brainer. Thanks so much for any feedback.
wishing you and your family good health in the new year.
Karen

Hi,

If your father is over age 80, the newest evidence says that BCG is not as effective for that population; it is also known that BCG isn't helpful for low grade papillary TCC, and is more useful for high grade tumors and CIS- carcinoma in situ. Did he have those? Otherwise...

Maybe your father's doctor is old fashioned, not up on the latest research. Or else he might have done the latest recommendation of ONE shot of a chemo in the bladder post-TUR/resection. My second cousin is 89, and she did that (Mitomycin post TUR), it hurt for a day or two but did keep her clear for a year or more. She could not tolerate BCG, and that was before that info about those over 80 not responding very well to BCG anyway.

If you need references, it was Michael O'Donnell who published that research.

Hard choices..it's about quality, though.

Wishing you and your family well.
Wendy

Thank you all so much for your input. I will be placing a call to the uro next week. The pathology report was only as specific as I previously stated, non-invasive, low-grade papillary tcc. No other staging, so that will be my first question to the uro. Also, my father occasionally has "accidents" now, mainly because he is unable to get out of bed quickly enough. I am about the toxicity of the bcg and possible exposure to my mother. The web sites have also been extremely helpful. I'll update after I talk to the uro. thanks to all.............