Bacillus Calmette-Guérin (BCG) treatment is a common immunotherapy for certain types of bladder cancer. Patients and their families often have questions about transmitting the bacteria to others. This article clarifies the nature of BCG and the necessary precautions to ensure safety during treatment.
What is BCG Treatment?
BCG treatment utilizes a weakened, live strain of Mycobacterium bovis, the same bacterium used in the tuberculosis vaccine. This immunotherapy is primarily administered directly into the bladder through a catheter to treat early-stage bladder cancer that has not spread into the muscle layer. Once inside the bladder, the BCG bacteria stimulate the body’s immune system to recognize and attack cancer cells. This localized approach helps reduce the risk of cancer recurrence within the bladder lining.
Is BCG Treatment Contagious?
BCG treatment is not contagious through casual contact or airborne transmission like a common cold. The bacteria used are weakened and are instilled directly into the bladder, not entering the bloodstream or respiratory system in a way that would lead to shedding through coughing or sneezing. However, the live bacteria can be present in a patient’s urine for a period after treatment. This means that direct exposure to urine can pose a risk, particularly to individuals who are immunocompromised.
While patients are not contagious through normal interaction, their bodily fluids, specifically urine, contain the live bacteria. Exposure to contaminated urine could lead to infection. Therefore, specific precautions are necessary to manage this temporary presence of bacteria and prevent accidental transmission through proper hygiene and urine disposal.
Specific Precautions After Treatment
Patients and caregivers must follow specific precautions immediately after treatment to prevent exposure to live bacteria in urine. It is recommended to sit while urinating to minimize splashing. After each urination, add two cups of undiluted household bleach to the toilet, close the lid, and allow it to sit for 15 to 20 minutes before flushing. Hands and the genital area should be thoroughly washed with soap and water after each void.
Contaminated clothing or towels should be washed separately in a washing machine with normal detergent and hot water. Individuals should avoid using public toilets during the initial hours following treatment. Sexual activity should also be avoided for a period, typically 24 to 48 hours after treatment, and condoms should be used during the entire course of BCG therapy and for several weeks afterward to protect partners.
How Long Do Precautions Last?
The most stringent precautions for urine disposal are typically required for about six hours after each BCG treatment session. During this timeframe, live bacteria are most concentrated in the urine. Patients are advised to drink plenty of fluids during these hours to help flush the bladder.
While immediate urine precautions last a few hours, some guidelines suggest continuing specific hygiene practices, like careful handwashing, for several days. Precautions for sexual contact, including condom use, may extend throughout the entire course of BCG treatment and for several weeks after therapy completion. Although BCG may persist in the urinary tract for several months, the period requiring strict disposal measures is much shorter. Healthcare providers will provide specific guidance tailored to each patient’s treatment plan.