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Actos Attorneys: The exact mechanism(s) of BCG is still not fully understood. It is known BCG actually attaches to and enters cancer cells. BCG is thought to trigger an increased immune reaction in the bladder, thereby killing off cancer cells. BCG is held in the bladder for two hours. One should not hold it longer as adverse reactions are increased. The individual should then void into a toilet at home, preferably in a seated position to avoid splashing. After voiding, the toilet is disinfected with bleach. Since BCG can be shed from the urethra after treatment for several days, condoms should be used or one should abstain from sexual relations for at least 48 hours after treatment.

Studies have shown an approximately 40% reduction in tumor recurrence in those treated with BCG as compared with those without treatment.For those with CIS, the reduction is even greater at approximately 70%. For individuals with residual tumors after resection, complete response is generally about 60%.Despite intravesical therapy, ultimately between 10-20% of individuals with superficial bladder cancer will develop muscle invasive disease.

After a 6 week induction course of weekly BCG, treatment is often repeated with 3 weekly treatments at 3 months, 6 months and then every 6 months for up to 3 years. This regimen was shown to decrease recurrences and increase complete responses as compared to induction treatment alone. Unfortunately, despite initial success, over long periods of time, many will experience disease recurrence and progression.Treatment regimens can be individualized based on the patient’s progress and his adverse reactions to treatment, which generally increase with repeated cycles.

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Adverse reactions are side effects of treatment. Approximately 95% of individuals will tolerate treatments well. Adverse reactions may be mild. Common reactions include cystitis (inflammation of the bladder characterized by burning on urination), hematuria, mild fever, malaise, and nausea. These symptoms generally pass without any treatment. For bothersome symptoms, various medications may prove helpful. Your physician can prescribe medication for burning or urinary frequency. For those with persistent cystitis, antibiotics can be utilized. For individuals experiencing severe symptoms lasting more than 48 hours, isoniazid, an anti-tuberculous drug can be prescribed. A short course of 3 days, starting the day before the next dose of BCG can be used to prevent severe side effects. Fortunately severe reactions resulting in sepsis, a life threatening condition characterized by high fever, chills and drop in blood pressure, is exceedingly rare. Sepsis would be treated in a hospital with triple anti-tuberculous drugs, steroids, and broad spectrum antibiotics.

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As treatment cycles progress, generally adverse reactions increase in severity, the most common being cystitis. Patients should not receive additional doses until they are asymptomatic. Studies have demonstrated increasing the intervals between treatments and reducing the dose of the BCG can still result in perhaps equal efficacy, but with reduced toxicity. BCG therapy results in marked inflammation of the bladder wall. Cystoscopy done too soon after therapy would reveal a markedly reddened surface, making finding a bladder tumor difficult. Furthermore, microscopically, there will be severe reactive changes, complicating the pathologist’s job, as deciding between changes from the BCG and recurrent cancer, would be extremely difficult.

Recurrence of bladder cancer after the initial induction course, or relapse after complete response, would indicate failure of therapy. When two or more courses result in recurrence or when recurrence develops during the first six to twelve months after induction and maintenance therapy, patients generally are felt to have disease which is at higher risk for progression. A high percentage of patients who are complete responders remain tumor free for up to five years. However, with the passage of more time, additional patients will have late recurrences. For those with late recurrences (two to three years after therapy), most will respond to repeat BCG therapy.

Our use of the term or terms Actos Attorneys is for descriptive purposes only. There is no relationship between the owners of this website and the maker of the product discussed in this post. Our use of the words Recall, Class Action Lawsuit and other similar words related to an event do not necessarily mean that this event has occurred. Refer to the website of the United States Food and Drug Administration for information on drug or medical device recalls. If a Class Action Lawsuit is formed in relation to the product discussed in this post we will provide that information at the time the Class Action is formed. A Class Action Lawsuit is not required to exist for you to file a lawsuit if you have been injured by the product discussed in this post.

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Actos Attorneys: Recent studies have shown the combination of BCG with Interferon results in greater efficacy in treating bladder cancer than either agent alone.^[1]A lower dose of BCG is mixed with Interferon and both are infused via a catheter into the bladder. Since a lower dose of BCG is used, the treatments are generally well tolerated. After an induction phase of 6 treatments, the patient is cystoscoped to determine response. If there is a good response, maintenance therapy with repeated treatments follow.

Laser therapy can be used to destroy superficial bladder cancers. It can prove particularly useful for treatment of tumors that cannot be reached with a standard resectoscope (such as tumors on the dome of the bladder in an obese individual). Generally, it is well tolerated with minimal bleeding. The disadvantage is the lack of pathologic specimen. Another modality, photodynamic therapy, was first reported in 1976. A photosensitizer is injected intravenously followed by whole bladder laser light therapy. Photofrin is approved by the FDA as a photosensitizer. It accumulates at a higher rate in rapidly dividing cells (the norm for cancer). When activated by light energy, the photosensitizer causes cell destruction. This therapy can eradicate superficial disease and CIS refractory to BCG therapy. Unfortunately, the therapy causes severe local inflammation and can lead to bladder contracture (shrunken bladder) in up to 20% of patients. It is accomplished under general anesthesia. Also, because the skin is also sensitized, the individual having treatment needs to avoid sun light or bright light for approximately 6 weeks. This therapy is available in only limited tertiary care centers. It may be justified as a last option in the hopes of avoiding cystectomy. Initial response rates may be as high as 50%.

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If you are still smoking, quit! Studies have shown those patients with bladder cancer that continue to smoke do worse than those who quit. Likewise, avoid exposure to any toxins which can lead to bladder cancer. Additionally, megadoses of vitamins in conjunction with BCG have been shown to reduce recurrence rates by as much as 40%, primarily in low grade, superficial disease. Antioxidant vitamins in combination were used.

They present in an identical fashion as superficial bladder cancers. They may present with hematuria, irritative voiding symptoms, or can be found by accident on an ultrasound or X ray exam. On occasion, an individual may pass pieces of the tumor in his urine. The vast majority do follow an initial presentation with superficial disease. However, approximately 25% of patients first present with serious invasive bladder cancer. Invasive bladder cancers are almost always high grade. They are aggressive cancers and can spread rapidly. They are usually larger than superficial bladder cancers. These cancers can spread directly through the bladder wall, invading tissues outside the bladder and adjacent organs such as the prostate. They can spread via lymphatics, first to the pelvic lymph nodes and then throughout the body through the lymphatic system. More rapid spread to distant organs can occur through the venous system.

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Radical cystectomy will cure approximately 75% of patients whose cancer is confined to the bladder muscle. Although individuals with minimal spread of cancer beyond the bladder may at times be cured with surgical removal of the bladder, even minimal disease outside the bladder may also be accompanied by metastatic disease, which cannot be cured by surgery alone. Therefore, microscopic spread through the bladder wall is a very bad prognostic finding. In general, larger cancers which have spread beyond the bladder to contiguous areas have a worse prognosis than cancers confined to the bladder with early spread to the surrounding lymph nodes. The more nodes involved outside the bladder by cancer, the worse the prognosis.

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Actos Attorney12/15/2011: Bleeding is usually present, but rarely severe. Some tumors are more vascular than others and will bleed more. In addition, the resection will involve the bladder wall and vascularity varies here as well. Transfusions are not generally required unless an individual starts with a low blood count from previous bleeding or medical condition. Bleeding can be an on going concern until the bladder completely heals weeks later. Catheterization and irrigation may be required. Just a small amount of blood will change the color of urine red. Urine that is punch colored or the color of rosé wine generally is not serious and will clear on its own. When the urine has large amounts of blood in it, the appearance generally looks like tomato juice, indicating serious bleeding requiring medical attention.

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Our use of the Terms Actos FDA Recall, Actos Litigation is not intended to imply or insinuate that there is any relationship or connection between Best Legal Source and the maker of Actos. Actos is a trademark of its manufacturer, Takeda Pharmaceutical Company Limited. Best Legal Source is not the maker of Actos nor do we have any connection with Takeda Pharmaceutical Company Limited.

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