BCG and Epirubicin instillation therapy

BCG is a weakened strain of bacteria that activates the immune system in the bladder. This stimulates the body's own defense cells to attack and eliminate remaining cancer cells. Studies have shown that BCG therapy can effectively help prevent relapses and slow the progression of the disease.

The treatment typically begins a few weeks after a transurethral resection of the bladder tumor (TURB). The standard protocol includes an induction phase with six weekly instillations, followed by maintenance therapy for up to three years.

BCG instillation therapy is performed via a catheter inserted into the bladder. The medication is heated to optimize its effect. After catheter insertion, the medication circulates in the bladder for about an hour, making contact with the bladder wall to achieve a therapeutic effect. During this time, the patient should remain still and comfortable.

Bladder irritation (frequent urination, burning)
Flu-like symptoms (fever, fatigue)
In rare cases, systemic infection may occur

Despite potential side effects, BCG remains the preferred treatment for high-risk patients because it offers the best long-term outcomes.

Epirubicin is a chemotherapy drug that is injected directly into the bladder to target cancer cells. It is particularly used in patients with an intermediate risk of recurrence.

The first Epirubicin instillation usually occurs within 24 hours after TURB. Additional treatments often follow in a fixed schedule over several weeks or months. The instillation process involves inserting a catheter into the bladder, warming the medication to optimize its effect. The drug circulates in the bladder for about an hour to thoroughly contact the bladder wall. During this time, the patient should remain still to allow the medication to work effectively.

Mild bladder irritation
Occasionally cystitis

Epirubicin is generally well tolerated and is particularly effective in the early phase after tumor removal.