Is burning urine after BCG a sign of bladder cancer return?

Question

Hello doctor,

My uncle, aged 70, was treated for bladder cancer with TURBT followed by BCG instillations. His latest cystoscopy showed mild inflammation but no recurrence. Lately, he complains of burning urine and occasional blood spots.

Could this be due to BCG side effects, or might it suggest early recurrence?
How frequently should cystoscopy be repeated for follow-up?
Are there newer tests, like urine cytology or biomarkers, that can detect recurrence earlier?
Also, can increasing water intake help flush out the bladder or reduce irritation, or does that not make much difference in preventing further inflammation after such treatments?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I hope you are well, and I wish your uncle a speedy recovery. I understand and appreciate the fear and anxiety you are feeling just from seeing blood in the urine after we performed the TURBT (transurethral resection of bladder tumor, which is a common procedure to diagnose and treat early-stage bladder cancer) and took the BCG (Bacillus calmette-guérin, a vaccine for tuberculosis, a bacterial infection that usually affects your lungs).

I want to reassure you that there is an inflammatory reaction that can occur in the bladder after the BCG. However, as long as the cystoscopy shows no cancer cells, only inflammatory cells, there is no problem and no need to worry.

We usually wait three months after the last cystoscopy. If symptoms increase, we may repeat the cystoscopy sooner. But if the symptoms are mild, without pain or significant bleeding, we wait and perform the next cystoscopy after three months to make sure there is no further metastasis.

I want you to be reassured and to reassure your uncle that the situation is manageable. We can control the disease, and even if it returns, we can achieve full control and full recovery. Treatments are improving every day, so there is no need to be afraid or live in anxiety. Live your life calmly, knowing that everything is under control.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.