BCG immunotherapy for bladder cancer
Intravesical BCG is a well-established, targeted treatment for bladder cancer that activates your own immune system to fight cancer cells. The in-office procedure itself takes just 60 seconds — the real work happens during the hour that follows.
Understanding intravesical BCG
BCG — Bacille Calmette-Guérin — is an immunotherapy agent consisting of a weakened form of the tuberculosis bacterium. When instilled directly into the bladder, it triggers a localized immune response that helps the body recognize and attack bladder cancer cells. It has been used for decades as a standard treatment for certain types of bladder cancer.
During the procedure, a small catheter is gently inserted into the bladder through the urethra under local anesthesia. The BCG solution is then instilled into the bladder, the catheter is removed, and you’ll be asked to hold the medicine in your bladder for one hour to give it time to work.
How BCG works
BCG doesn’t kill cancer cells directly — instead, it activates your immune system to do that work.
Your immune system does the work
BCG bacteria signal the immune system that something foreign is present in the bladder.
Immune cells respond to the BCG and migrate to the bladder lining where they begin patrolling.
The activated immune cells recognize and destroy remaining cancer cells along the bladder wall.
The essentials
60 seconds
The actual instillation takes just one minute
Local anesthesia
Numbing gel makes catheter insertion comfortable
No prep needed
No special preparation beforehand
Drive yourself
No sedation — drive yourself home
What to expect
Arrive & settle
No preparation needed — arrive ready.
Local anesthesia
Anesthetic gel is applied to numb the area.
BCG instilled
Catheter inserted, BCG instilled (~60 seconds), catheter removed.
Begin the hold
Leave the office and hold the medicine for 1 hour.
The one-hour hold
After the BCG is instilled, you’ll be asked to hold the medicine in your bladder for one hour. This time gives the BCG direct contact with the bladder lining — which is essential to its effectiveness. You do NOT need to remain in the office during this hour.
Try to avoid urinating until the full hour has passed. After that, urinate normally — and follow the safety precautions below for the first several hours.
After the one-hour hold
Because BCG contains live bacteria, certain bathroom precautions are recommended for the first approximately 6 hours after treatment.
Sit while urinating
Men and women should sit while urinating to minimize splashing for the first several hours after treatment.
Disinfect the toilet
After each urination during the first ~6 hours, add household bleach to the toilet, let stand 15 minutes, then flush.
Wash hands thoroughly
Wash your hands carefully with soap and warm water after using the bathroom for the first several hours.
Increase fluid intake
Drink extra water for the rest of the day after your treatment to help flush the bladder.
Normal aftereffects & warning signs
Some aftereffects are expected and indicate your immune system is responding. Others warrant a call.
What’s normal
When to reach out
Schedule your BCG treatment.
If your provider has recommended BCG immunotherapy, schedule with our urology team. We provide compassionate care throughout your treatment course — and we’ll make sure you understand every step.