June 10, 2009

Not much to report..... Claudia has arrived for for a visit..... We have been exploring the area, and are planning a 3 day kayak trip down the river with the local paddling club. Claudia has a background in the insurance business, and has been kind enough to help me start to sort out the mountain of paper generated by the health care providers and the insurance co. Without her help I might survive the cancer, but succumb to the paperwork.

BCG (a weakened form of the tuberculosis bacteria) treatments are underway, (every Wed. at 2:00 PM) irritated urethra.... irritated bladder.... but no major negative side effects yet. This type of treatment seems relatively easy on the body compared to chemo and radiation. (See description below.) I am trying to remember that things could be much worse...... some days, it doesn't seem to help.

What is TICE® BCG and how does it work?

TICE® BCG is a bacterial preparation of a strain called Bacillus Calmette-Guerin (BCG). It contains live, attenuated bacteria. The medication was developed as a vaccine against tuberculosis but has been found to be useful in treating certain bladder cancers. Doctors have been using TICE® BCG for many years to treat and help prevent recurrence of tumors in patients with bladder CIS. It is also used following TUR to help prevent recurrence of Ta and T1 papillary tumors.

How BCG works to treat bladder cancer is not completely understood. A partial explanation may be that it appears to produce an inflammation in the lining of the bladder but the precise mechanism is not known.

In order to work, BCG must be in direct contact with the tumor cells. That’s why it is instilled -- administered directly into the bladder -- instead of being given by injection. BCG can be effective in treating and helping to prevent the return of bladder CIS. It also can be considered to be effective in helping prevent papillary tumors from coming back following TUR.

What occurs during TICE® BCG treatment?

The instillation -- pouring the medicine into your bladder -- takes only a few minutes. However, the medicine must stay in your bladder for 2 hours. The process itself is simple.

A tube (a catheter) is passed through your urethra and into your bladder. Any urine that remains in your bladder can then be removed so that the BCG can easily touch all of the bladder lining.

The TICE® BCG mixture is administered into your bladder through the catheter.

The medication stays in your bladder for 2 hours. During that time, you will be lying down. Your position will be changed from time to time to make sure that the BCG is in contact with all parts of the lining of the bladder long enough to be effective. Lying down and changing position may also help to reduce the urge to urinate during the treatment period.

What are the common side effects of treatment with TICE® BCG?

You should talk to your doctor about possible side effects associated with TICE® BCG treatment. Some reactions such as painful or frequent urination can be related to irritation of the bladder. These symptoms typically begin 4 to 6 hours after instillation and last 24-72 hours. They are usually seen after the third treatment and tend to increase in severity after each administration. Other symptoms, such as flu-like symptoms, fever, fatigue, and chills may affect your whole body. These symptoms also may get more frequent or worse with subsequent treatments.

Notify your doctor at once if you experience any problems, particularly severe urinary symptoms such as burning or painful urination, an urgent or frequent need to urinate, or blood in the urine. Also report joint pain, coughing, or rash. It is especially important to report these symptoms to your doctor before you receive the next treatment of BCG. They may be a sign that you have an infection requiring immediate attention. You should be aware that infections associated with TICE® BCG treatment have led to death on rare occasions. Symptoms lasting longer than 48 hours or a fever of 101.3°F (or higher) should be reported to your physician immediately.