Microscopic view of bladder cancer cells being treated with BCG and Chemohyperthermia.

Is BCG Still the Gold Standard for Bladder Cancer? Weighing the Odds Against Chemohyperthermia

Rhea Morgan in Health & Wellness August 2025 • 4 min read.

"A new study explores whether chemohyperthermia can rival the effectiveness of BCG for high-risk, non-muscle-invasive bladder cancer."

Bladder cancer is a common and serious diagnosis, especially for men. The good news is that if caught early, specifically when it’s non-muscle-invasive bladder cancer (NMIBC), the chances of survival are high – over 90%. The challenge, however, lies in preventing the cancer from recurring after initial treatment.

Following the removal of the tumor through a procedure called transurethral resection (TUR), many patients face a tough reality: the cancer can come back. To combat this, doctors often recommend adjuvant intravesical therapy, where medication is placed directly into the bladder to reduce the risk of recurrence and progression. The European Association of Urology (EAU) supports this approach, with one of the mainstays of treatment being the Bacillus Calmette-Guérin, more commonly known as BCG.

BCG has been a go-to treatment, but it's not without its drawbacks. The side effects can be difficult, leading researchers to explore new options. One such alternative is chemohyperthermia (C-HT), which combines chemotherapy with heat to target cancer cells. While promising, there has been a lack of direct comparisons between BCG and C-HT – until now. A recent study has taken on the challenge of comparing these two treatments, offering valuable insights for those navigating bladder cancer treatment options.

BCG vs. Chemohyperthermia: A Head-to-Head Comparison

Microscopic view of bladder cancer cells being treated with BCG and Chemohyperthermia.

Researchers conducted a retrospective study analyzing data from 1,937 patients diagnosed with bladder cancer between January 2004 and January 2014. The goal was to compare how well C-HT and BCG prevent cancer recurrence. Patients treated with C-HT were carefully matched with those treated with BCG, ensuring a fair comparison. Statistical models were then used to determine the link between the treatments and the likelihood of recurrence or progression.

Out of the 710 patients who received intravesical treatments, a select group was chosen for the C-HT (40 patients) and BCG (142 patients) groups. After matching patient characteristics, the study revealed some key differences:

The two-year recurrence-free interval was 76.2% in the C-HT group compared to 93.9% in the BCG group.
Treatment with C-HT was linked to a higher risk of tumor recurrence.
High-grade tumors were also associated with an increased risk of recurrence.
However, in more complex analysis, C-HT didn't show a statistically significant difference from BCG in terms of recurrence risk.
There were no significant differences in progression rates between C-HT and BCG.

The results suggest that C-HT may not be as effective as BCG in preventing recurrence in BCG-naive, high-risk NMIBC patients. While BCG significantly improved the recurrence-free interval, C-HT did not achieve the same level of success.

The Bottom Line: BCG Still Reigns, But the Search Continues

This study indicates that for patients with high-risk NMIBC who haven't been treated with BCG before, BCG remains the more effective option. While C-HT shows promise, more research is needed to refine its application and determine its potential role in bladder cancer treatment. As the quest for better treatments continues, it’s vital for patients to discuss all options with their healthcare team to make informed decisions based on their individual needs and circumstances.

About this Article -

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Everything You Need To Know

What exactly is BCG treatment for bladder cancer?

BCG, or Bacillus Calmette-Guérin, is a type of intravesical therapy used to treat high-risk, non-muscle-invasive bladder cancer (NMIBC) after a transurethral resection (TUR). It involves placing medication directly into the bladder to reduce the risk of the cancer returning. BCG has been a standard treatment for many years, recommended by organizations like the European Association of Urology (EAU), due to its effectiveness in preventing recurrence. However, it can cause side effects, which has led to the exploration of alternative treatments.

What is chemohyperthermia, and why is it being considered for bladder cancer?

Chemohyperthermia (C-HT) is an alternative treatment for bladder cancer that combines chemotherapy with heat to target cancer cells. It's being investigated as a potential option for patients with high-risk NMIBC. The significance of C-HT lies in the possibility of offering a different approach for patients who may not be suitable for BCG or for whom BCG is not effective. While promising, studies are ongoing to determine its effectiveness compared to BCG.

What is transurethral resection (TUR), and why is it mentioned in the context of bladder cancer treatment?

Transurethral resection (TUR) is a surgical procedure used to remove tumors in the bladder. It is typically the first step in treating non-muscle-invasive bladder cancer (NMIBC). After TUR, adjuvant intravesical therapy, such as BCG or chemohyperthermia, is often recommended to reduce the risk of the cancer recurring. TUR plays a critical role in initially addressing the tumor and setting the stage for further treatment to prevent recurrence.

What does adjuvant intravesical therapy mean in the treatment of bladder cancer, and why is it important?

Adjuvant intravesical therapy involves placing medication directly into the bladder after a transurethral resection (TUR) to prevent bladder cancer from recurring. Both BCG and chemohyperthermia (C-HT) fall under this category. This type of therapy is important because, after the initial tumor removal, there's a significant risk of recurrence, especially in high-risk cases. Intravesical therapy aims to target any remaining cancer cells in the bladder, reducing the likelihood of the cancer coming back or progressing to a more advanced stage.

What were the main findings of the study comparing chemohyperthermia and BCG treatments?

The study compared chemohyperthermia (C-HT) and BCG in preventing recurrence in patients with high-risk, non-muscle-invasive bladder cancer (NMIBC). The results indicated that BCG was more effective than C-HT in preventing recurrence. Specifically, the two-year recurrence-free interval was higher in the BCG group. While C-HT showed promise, it did not achieve the same level of success as BCG in this study. This suggests that, for patients who haven't been treated with BCG before, BCG remains the preferred option. Further research is needed to refine the application of C-HT and determine its potential role in bladder cancer treatment.