A practical guide to the use of intravesical BCG for the management of stage Ta, T1, CIS, transitional cell cancer.

Intravesical instillations of BCG are effective in preventing tumor recurrence, eliminating existing tumor and treating CIS in a substantial number of patients. As with any type of therapy, side effects can occur. Because a live organism is being used, care must be taken in the handling and administration of the product. Patients should be informed about the common types of reactions so that these may be reported to the urologist. In turn, the urologist must decide if the treatment plan needs to be modified or the patient started on medications which can prevent or reduce the severity of the side effects. At times a decision must be made regarding withholding or delaying treatment and there are situations when BCG should be stopped.