Bladder Cancer

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Before instillation
  • Do not drink any liquids for four hours before you are scheduled to receive BCG therapy. 
  • Please be prompt for your appointment because BCG may be mixed in advance to be ready for you.
  • Inform the nurse if you have had a fever, chills or been unusually tired since your last treatment.  Also, let us know if you have been urinating bright red blood or blood clots since your last treatment.
  • Urinate to empty your bladder just before the BCG treatment.


During the instillation
  • The medication will be installed into you bladder through a plastic tube called a catheter.
  • The catheter will be removed from the bladder immediately after the instillation is completed.
  • The medication should remain in your bladder for two hours to obtain the best results. If you must urinate before two hours, the medicine will still be effective, but let us know at your next visit how long you held the BCG.


After instillation
  • Remain active while the medication is in the bladder as this may help move the medicine around in the bladder.
  • After you have retained the medication in your bladder for two hours, sit down on the toilet to urinate and fully empty your bladder.
  • After urinating, pour two cups of household bleach (such as Clorox) into the toilet and close the lid.  Let stand for 15 minutes. 
  • Wash your hands and genital areas with soap and water after your urinate.
  • Repeat the above process each time you urinate over the next six hours.
  • Drink plenty of fluids.


Symptoms to watch for
  • You may experience some burning and frequency of urination, generalized discomfort, tiredness, flu-like symptoms or joint pain after your treatment.
  • There may be some blood in the urine. You should call if there is heavy bleeding in the urine or if there is fever over 100.5°F or chills. 


Follow up plan
  • Bladder cancer has a strong tendency to come back throughout your lifetime.  It is extremely important that you have lifelong follow up with your urologist to look in the bladder periodically and check the urine for cancer cells.
  • Bring your BCG Schedule to be signed off after each BCG cycle and each cystoscopy (look in the bladder).



The Urology Group.  Copyright 2014.  Do not duplicate without permission.

Reference:  Schimke, L. Intravesical therapy for bladder cancer. SUNA 43th Annual Conference. Lancaster, PA.