BCG IN THE TREATMENT OF SUPERFICIAL CANCER OF THE BLADDER - A REVIEW

Superficial Bladder Cancer can be treated in several ways. During the last decades, intravesical instillation of Bacillus Calmette Guerin (B CG) has emerged as an effective therapy. The history of how BCG became an antitumoral treatment is long and intriguing, and the theoretical background is fragile. In numerous studies, involving over 3,000 patie nts, intravesical instillation of BCG has been shown to be an effectiv e treatment for superficial cancer of the urinary bladder in humans. T emporarily, BCG can eradicate residual disease after surgery, it can p revent local recurrence, and it can halt deterioration of malignancy i n recurrences. However, its effect on survival is uncertain. For patie nts, treatment with BCG is prolonged, expensive, associated with side- effects, and may even be harmful. The mode of action is obscure. The t heoretical framework on which this therapy is based is purely speculat ive, if existing at all. Although BCG has been classified as a biologi cal response modifier, and the treatment is termed immunotherapy, proo f is still lacking that the mechanism is immunological.