When is intravesical BCG therapy recommended for bladder cancer?

BCG is placed into the bladder through a thin catheter rather than given through a vein. It stimulates a local immune response against abnormal cells left in the bladder. The decision depends on the tumour’s grade, depth, number, pattern of growth, recurrence history and the quality of the initial removal.

It is generally used for non-muscle-invasive bladder cancer when the team believes local treatment can reduce future risk. It is not the same as an antibiotic course, and it is not suitable during some active infections or when the bladder has not healed.

Ask how completely the tumour was removed, what the pathology shows and whether another bladder examination is needed. Follow instructions about fluids, urination and hygiene after each treatment. Tell the clinic about fever, urinary infection symptoms, blood in the urine, recent procedures or medicines that affect immunity.

See [Intravesical BCG Therapy](/treatments/systemic-therapy/intravesical-bcg-therapy/) and the [Bladder Cancer](/conditions/bladder-cancer/) overview for context.

Seek prompt medical advice for fever, chills, feeling very unwell, inability to pass urine, worsening pelvic pain, heavy or persistent blood in the urine, or breathing difficulty after BCG. These may signal infection, bleeding or a less common reaction that needs assessment.

What do the tumour grade and depth mean for my risk? Why is BCG preferred in my case? How many treatment visits are planned? When will the bladder be checked again? What should I do if I develop fever or urinary symptoms?