BCG immunotherapy for superficial bladder cancer

  • Donald L. Lamm
Part of the Cancer Treatment and Research book series (CTAR, volume 34)

Abstract

Transitional cell carcinoma of the bladder is an ideal tumor for the evaluation of cancer immunotherapy. Unlike most tumors, patients with transitional cell carcinoma of the bladder typically present with localized superficial disease which can be readily resected. After tumor resection patients are generally immunologically competent and adequately nourished, but have an approximately 70% risk of tumor recurrence. Such recurrences may be due to the implantation of tumor cells released during transurethral resection. Animal models suggest that traumatized urothelium is particularly susceptible to tumor implantation. Alternatively, tumor recurrence may be due to incomplete resection of the primary tumor, growth of microscopic tumors not visible to the endoscopist, or the generation of new tumors. New tumors may result from continued physical, chemical, or biological carcinogen exposure in a susceptible host or, more likely, from the progression of malignantly transformed cells from occult to overt malignancy. Multifocal atypia, loss of blood group antigens in normal appearing urothelium, and multifocal recurrences in patients with transitional cell carcinoma suggest that malignant transformation is widespread. Such microscopic or submicroscopic disease is accessible for topical therapy. It is presumably the combination of an immunocompetent host with an accessible, antigenic, microscopic or submicroscopic malignancy which has resulted in the successful immunotherapy of bladder cancer.

Keywords

Leukemia Tuberculosis Oncol Bacillus Interferon 

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Copyright information

© Martinus Nijhoff Publishers, Boston 1987

Authors and Affiliations

  • Donald L. Lamm

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