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BCG and Methotrexate

Darcy
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Recently diagnosed with G3 T1 and being offered the choice of mitomycin or cystectomy.  What a choice!  Mitomycin because I'm on methotrexate for psoriatic arthritis. However having spoken with Rheumatology their advice is that BCG, which I'm told is the 'Gold Standard', is perfectly OK if I reduce the methotrexate dose down to 15mg a week.  Urology don't seem convinced.

Has anyone had experience of mixing methotrexate with BCG?

All this is new to me and I opted for chemo because the thought of losing my bladder was just too much.  So my plan is to go with chemo or BCG if allowed and then at the first sign of recurrence, swallow hard and go for cystectomy.  Does that make sense?

So glad I found this forum.

  • Hi

    Not on methotrexate but do have PA. Diagnosed with nmibc tag3 with cis over two years ago. At the time I did some research because if my PA gets worse methotrexate is an option. I found that in the NHS it is contra indicated with a risk rating of "severe". But the risk is tagged as "theoretical".

    I also found papers on treatment of skin cancer with bcg and methotrexate which did not find any benefit over conventional treatment but I dont think there were any interaction of the two drugs. BCG is the gold standard so I would investigate further or get a second opinion as I dont think its cut and dried. Also what if you stop the methotrexate for a while Im not sure how long it takes to clear your system, good luck.

    Ptag3 + cis 18 bcg no reccurance.

  • in reply to Bsk7f940d

    Many thanks for picking up on my quandary.  Armed with your encouragement I'm going to needle Urology further to examine carefully the advice I had from Rheumatology. We'll see.

    You've had 2 years and no recurrence for which I'm sure you are grateful.  Long may that be the case, for both of us..

  • in reply to Darcy

    Good luck

    Please let us know the result there must be many more bc patients with PA who would like to know.

    Best regards

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