Bladder cancer is one of the most commonly diagnosed cancers of the urinary system. Fortunately, when detected early, it is highly treatable. One of the most effective and widely used treatments for Non-Muscle Invasive Bladder Cancer (NMIBC) is BCG therapy. This treatment has been a gold standard for decades and continues to play a crucial role in preventing recurrence and progression of bladder cancer.
In this blog, we will explain what BCG therapy is, how it works, its benefits, possible side effects, success rate, and what patients can expect during treatment.
What Is BCG Therapy?
BCG (Bacillus Calmette–Guérin) therapy is a type of intravesical immunotherapy, meaning the treatment is delivered directly into the bladder. BCG is a weakened form of bacteria originally developed as a vaccine for tuberculosis, but it has been successfully used to treat bladder cancer since the 1970s.
BCG therapy is mainly recommended for patients with:
Non-Muscle Invasive Bladder Cancer (NMIBC)
High-grade tumors
Carcinoma in situ (CIS)
Recurrent superficial bladder cancer
How Does BCG Therapy Work?
Unlike chemotherapy, BCG does not directly kill cancer cells. Instead, it stimulates the body’s immune system.
When BCG is placed inside the bladder:
It activates immune cells in the bladder lining
These immune cells recognize and attack cancer cells
This reduces the chance of cancer recurrence and progression
By strengthening the body’s natural defense mechanism, BCG creates a hostile environment for cancer cells to grow.
When Is BCG Therapy Given?
BCG therapy is usually given after TURBT (Transurethral Resection of Bladder Tumor). TURBT removes visible tumors from the bladder, and BCG therapy helps eliminate microscopic cancer cells that may remain.
Typical BCG Treatment Schedule:
Induction phase: Once a week for 6 weeks
Maintenance therapy: Additional doses over months or years, depending on risk level
Your uro-oncologist will decide the exact schedule based on tumor type and stage.
Benefits of BCG Therapy for Bladder Cancer
BCG therapy offers several important advantages:
1. Reduces Cancer Recurrence
BCG significantly lowers the risk of bladder cancer coming back after surgery.
2. Prevents Disease Progression
It reduces the chance of superficial cancer progressing into muscle-invasive disease, which requires more aggressive treatment.
3. Bladder Preservation
BCG helps many patients avoid radical bladder removal (cystectomy).
4. Proven Long-Term Results
BCG has been used for decades with strong evidence supporting its effectiveness.
5. Targeted Local Treatment
Since BCG is given directly into the bladder, it minimizes whole-body side effects.
Success Rate of BCG Therapy
BCG therapy is considered the most effective treatment for high-risk NMIBC.
Success rate: Approximately 60–70% of patients respond well
Recurrence reduction: Up to 50–60% decrease in recurrence risk
Progression prevention: Significantly lowers progression to muscle-invasive cancer
Patients who complete both induction and maintenance therapy have the best long-term outcomes.
Side Effects of BCG Therapy
Most patients tolerate BCG therapy well, but mild to moderate side effects are common and usually temporary.
Common Side Effects:
Burning or pain during urination
Increased urinary frequency and urgency
Mild fever and fatigue
Blood in urine (temporary)
Bladder discomfort
Less Common but Serious Side Effects:
High fever lasting more than 48 hours
Severe bladder inflammation
Systemic BCG infection (rare)
Patients should immediately inform their doctor if symptoms are severe or persistent.
Who Should Not Receive BCG Therapy?
BCG therapy may not be suitable for patients with:
Active urinary tract infection
Severe immune system disorders
Recent bladder surgery with poor healing
Gross hematuria (heavy bleeding)
Your doctor will carefully evaluate your condition before starting treatment.
Life During and After BCG Therapy
During treatment:
Patients can continue daily activities
Drinking plenty of fluids is advised
Sexual precautions may be recommended temporarily
After treatment:
Regular follow-up cystoscopies are essential
Long-term monitoring is required as bladder cancer can recur
Early detection of recurrence ensures prompt treatment and better outcomes.
Expert Care by Dr. Rahul Jena
Dr. Rahul Jena is a Consultant Uro-Oncologist at Bagchi Sri Shankara Cancer Centre & Research Institute, Bhubaneswar, with specialized expertise in bladder cancer management. He is experienced in:
TURBT procedures
BCG therapy planning and monitoring
Robotic and minimally invasive uro-oncology surgeries
Personalized cancer treatment strategies
His patient-centric approach ensures accurate diagnosis, evidence-based treatment, and compassionate care.
📍 Location: Bagchi Sri Shankara Cancer Centre & Research Institute, Bhubaneswar
📞 Appointments: +91 9938534048
🌐 Website: www.rahuljenaurology.com
Conclusion
BCG therapy remains the cornerstone treatment for Non-Muscle Invasive Bladder Cancer. It offers excellent long-term control, reduces recurrence, and helps preserve the bladder when used appropriately. While side effects may occur, they are usually manageable under expert supervision.
If you or a loved one has been diagnosed with early-stage bladder cancer, consulting an experienced uro-oncologist like Dr. Rahul Jena can help you make informed treatment decisions and achieve the best possible outcome.
Early treatment saves lives—and BCG therapy continues to be a powerful weapon against bladder cancer.