What to expect from intravesical BCG therapy for bladder cancer

BCG is given directly into the bladder rather than through a vein. During an appointment, a healthcare professional passes a thin catheter through the urethra and instils the medicine. You may be asked to keep it in the bladder for a set period before urinating. Treatment is commonly organised as a course of visits, with later maintenance visits depending on your cancer and treatment plan.

Burning when passing urine, needing to urinate often, pelvic discomfort, tiredness, a mild fever or aching can occur after treatment. These effects may settle over a short time, but your team will explain what is expected for you. The medicine can irritate the bladder, so fluid advice and hygiene instructions matter.

Tell the clinic before an appointment if you have a urinary infection, visible blood in your urine, difficulty passing urine, or a recent bladder procedure. Follow the instructions about medicines, fluids and arriving with an appropriately prepared bladder. After treatment, follow the clinic’s toilet and cleaning guidance, wash your hands carefully, and drink as advised. Plan rest if you feel tired and record symptoms between visits.

Contact your treatment team urgently for a high or persistent fever, chills, marked weakness, confusion, trouble breathing, inability to pass urine, or worsening pain. Also report heavy blood in the urine or symptoms that do not improve as the team predicted. Do not wait for the next appointment if you feel seriously unwell; BCG-related infection needs prompt assessment.

Ask how long to keep the medicine in the bladder, which symptoms should be reported the same day, and how to manage work, exercise, sex and travel during the course. Confirm what to do if you miss an appointment or develop urinary symptoms before the next dose.