As has been mentioned, BCG has been shown to be effective in doses as low as 1/10th the usual dose. Due to increasing side effects (irritation of the bladder lining) by the time I was finished with the sequence I was down to 1/3 the initial dose. I was treated for high grade CIS and am now 6 years cancer-free!!
The history of BCG use in bladder cancer is an interesting one. It was initially used in the 1920's as a safer vaccine against TB in children. It has not been used for that in many decades. When researchers started to try anything on hand against many cancers, BCG was one of those tried. For a while it was thought that it might be effective against malignant melanoma, but that turned out not to be the case.
When BCG was tried and shown to be effective against high grade bladder cancer, the dose used was the one in the vials provided by the drug company. There has never been a clinical trial which determined the optimal effective dose!
Dr. Donald Lamm in Phoenix, AZ, is one of the pioneers and experts in the use of BCG in bladder cancer. You may find his summary very interesting:
Interferon is sometimes added to BCG when BCG alone has been ineffective and it is also used alone in the few cases where BCG has caused too many side effects in a particular patient.
I guess that I would want to ask the urologist why not use just the 1/3 dose BCG alone and, if it is not effective, then go to the combination.
Please remember that we are NOT doctors, but only patients who have "been there, done that." You need to depend on your urologist and your own common sense...but this is something worth discussing.
Best of luck to you and your dad. He is lucky to have you in his corner.
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
I was recently diagnosed with bladder cancer so i don't know much yet. But I remember somebody on this board said that BCG can be decreased a lot without decreasing it's effect. Interferon was added to BCG for some patients when the BCG alone did not work out. But other people will know more for sure.
66yo female, 1992-Non-Hodg. lymphoma(NHL) high grade, chemo, rads, 2007 NHL, low grade, rads, 2013 NHL low grade, stage 4, chemo till Jan 2015; 2014 TCC, first Turb 01/29/2015.
My dad is 81 and was diagnosed with early stage high grade non invasive BC. He is scheduled to begin BCG treatments in a week. With the shortage it is 1/3 BCG and 50,000 units of interferon. I am wondering if there are specific questions we should ask about interferon combined with BCG? I have only read up on the 2 separately. I am thinking side effects, stats on success rates, etc.