Intravesical BCG: where do we stand? Past, present and future

High and intermediate risk non-muscle invasive bladder cancer poses a real challenge for treatment. Approximately 70% of bladder cancer presents as non-muscle invasive and 20-25% will progress to muscle invasive disease. Recurrences occur in up to 70% but treatment options are limited. Intravesical bacillus Calmette-Guerin is still considered the bladder sparing treatment of choice despite its well documented pitfalls. This review considers how bacillus Calmette-Guerin has become the recommended treatment, its benefits and risks and the alternative options for treatment.