Illustration of a bladder protected by BCG, fending off cancer cells.

BCG vs. Chemohyperthermia: Which Bladder Cancer Treatment is Right for You?

Avery Sinclair in Health & Wellness August 2025 • 4 min read.

"A new study compares the effectiveness of BCG and chemohyperthermia for high-risk non-muscle-invasive bladder cancer. Find out which treatment shows more promise."

Bladder cancer is a major health concern, ranking as the fourth most common cancer among American men. The good news is that if caught early, when the cancer is non-muscle-invasive (NMIBC), the five-year survival rate is high. However, even with successful initial treatment, many patients face a risk of recurrence, making ongoing care essential.

After the initial tumor removal, patients with high-risk NMIBC often need additional treatments, called adjuvant therapies, to prevent the cancer from returning or progressing. Bacillus Calmette-Guérin (BCG), a type of immunotherapy, has long been a primary choice. However, because BCG can have significant side effects, researchers continue to explore new and improved options.

One such alternative is chemohyperthermia (C-HT), which combines chemotherapy with heat to target cancer cells. While several studies have suggested that C-HT could be beneficial, direct comparisons between BCG and C-HT have been lacking. Now, a new study sheds light on how these two treatments stack up against each other.

The Study: Comparing BCG and Chemohyperthermia

Illustration of a bladder protected by BCG, fending off cancer cells.

Researchers conducted a retrospective study to compare the effectiveness of BCG and C-HT in patients with high-risk NMIBC. The study included 1937 patients diagnosed with bladder cancer between January 2004 and January 2014. Of these, 710 patients received intravesical treatments (directly into the bladder), with some receiving C-HT and others receiving BCG.

To ensure a fair comparison, the researchers used a technique called propensity score matching to create two groups of patients with similar characteristics. This method helped to minimize bias and make the results more reliable. The primary goal was to see how long patients remained recurrence-free after treatment with either C-HT or BCG.

Patient Selection: The study focused on patients with high-risk NMIBC who underwent transurethral resection (TUR), a procedure to remove bladder tumors.
Treatment Groups: Patients were treated with either intravesical C-HT or BCG instillation. The C-HT involved using a special unit to heat the bladder wall while administering chemotherapy. BCG was given weekly for six weeks.
Follow-up: Patients underwent regular cystoscopies (bladder exams) and urine tests to monitor for recurrence.
Statistical Analysis: The researchers used statistical methods to compare the recurrence-free intervals between the two treatment groups and to identify factors associated with recurrence and progression.

So, what did the study find? The results showed that BCG was more effective than C-HT in preventing recurrence. The two-year recurrence-free interval was 76.2% in the C-HT group compared to 93.9% in the BCG group. This difference was statistically significant, meaning it was unlikely to be due to chance.

The Bottom Line: BCG Remains the Gold Standard, For Now

This study suggests that for patients with high-risk NMIBC who have not previously received BCG, BCG remains the more effective treatment option. While chemohyperthermia may offer an alternative for some patients, it did not perform as well as BCG in preventing cancer recurrence. However, it’s important to remember that this was a retrospective study, and more research is needed to confirm these findings. Future studies should also explore ways to improve chemohyperthermia or identify specific patients who might benefit most from this approach. If you have high-risk NMIBC, talk to your doctor about the best treatment plan for you.

About this Article -

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Everything You Need To Know

What is the primary purpose of adjuvant therapies in treating high-risk non-muscle-invasive bladder cancer?

Adjuvant therapies, such as Bacillus Calmette-Guérin (BCG) and chemohyperthermia (C-HT), are used after the initial tumor removal in patients with high-risk non-muscle-invasive bladder cancer (NMIBC). Their primary purpose is to prevent the cancer from returning (recurrence) or progressing to a more advanced stage. This is critical because even after successful initial treatment, there is a significant risk of recurrence, making ongoing care and additional treatments essential for many patients.

What is the difference between Bacillus Calmette-Guérin (BCG) and chemohyperthermia (C-HT) as bladder cancer treatments?

Bacillus Calmette-Guérin (BCG) is a type of immunotherapy that has been a primary treatment for high-risk non-muscle-invasive bladder cancer (NMIBC). It is administered directly into the bladder to stimulate the immune system to attack cancer cells. Chemohyperthermia (C-HT), on the other hand, combines chemotherapy with heat to target cancer cells. This approach involves using a special unit to heat the bladder wall while administering chemotherapy. The main difference lies in their mechanisms of action: BCG boosts the body's immune response, while C-HT uses a combination of chemotherapy and heat.

How did the study compare the effectiveness of BCG and chemohyperthermia (C-HT)?

The study compared the effectiveness of Bacillus Calmette-Guérin (BCG) and chemohyperthermia (C-HT) in patients with high-risk non-muscle-invasive bladder cancer (NMIBC) through a retrospective study. The study included 1937 patients. A technique called propensity score matching was used to create two groups with similar characteristics, minimizing bias. The primary goal was to compare the recurrence-free intervals between the two treatment groups. Patients were treated with either intravesical C-HT or BCG instillation and underwent regular cystoscopies and urine tests to monitor for recurrence. Statistical methods were used to compare the recurrence-free intervals and identify factors associated with recurrence and progression.

What were the key findings of the study comparing BCG and chemohyperthermia (C-HT) for bladder cancer?

The study found that Bacillus Calmette-Guérin (BCG) was more effective than chemohyperthermia (C-HT) in preventing recurrence of high-risk non-muscle-invasive bladder cancer (NMIBC). The two-year recurrence-free interval was 76.2% in the C-HT group compared to 93.9% in the BCG group. This difference was statistically significant, indicating that BCG was more likely to prevent the cancer from returning. The study highlights that for patients with high-risk NMIBC who have not previously received BCG, BCG remains the more effective treatment option, based on the study's results.

What should patients with high-risk non-muscle-invasive bladder cancer (NMIBC) consider regarding treatment options like BCG and chemohyperthermia (C-HT)?

Patients with high-risk non-muscle-invasive bladder cancer (NMIBC) should understand that Bacillus Calmette-Guérin (BCG) has been shown to be more effective than chemohyperthermia (C-HT) in preventing recurrence. However, the choice of treatment should be discussed with their doctor, considering individual factors, previous treatments, and potential side effects of each approach. While BCG is currently considered the gold standard, chemohyperthermia may be an alternative for some patients, and ongoing research aims to improve this treatment or identify specific patient groups who might benefit from it. Regular monitoring and follow-up care, including cystoscopies and urine tests, are crucial to manage the risk of recurrence and progression, regardless of the treatment chosen.