I am helping my dad fight cancer. One of the treatments used by the
alternative medical center we have gone to is administering the BCG
tuberculin vaccine. The TB vaccine has apparently been shown to be
effective in enhancing the body's immune system to melanoma, which is
his cancer type.
Our integrative medicine doctor is also aware of this treatment for
melanoma.
He told us of cases in which the vaccine was applied over a broad area
on the rib cage instead of the arm to get a better response to the
vaccine. I am looking for Documentation that supports this claim since
we will be returning to the medical center in about a week and he
currently shows negative for the PPD skin test given a few days ago. 
This indicates that the 'titers' are not present and that this is not
uncommon. In April he received two BCG vaccines when at the medical
center. However, if we can find some documentation that application to
the rib cage is more effective we may be able to get a better response
to the vaccine when given again.

---

Request for Question Clarification by techtor-ga on 30 Jun 2003 11:04 PDT

I couldn't find anything yet showing BCG injections in the rib cage. I
just found this document saying that the best places to inject it in
are the hip bone around the back and the upper arm:

BCG Vaccination - University of South Wales
http://www.micro.unsw.edu.au/Irwin/BCGVACCINATION1.html

It doesn't quite answer your question, so I posted it in the Request
for Clarification box.

---

Clarification of Question by dpage-ga on 30 Jun 2003 12:30 PDT

The only thing I can add to help in the search is I beleive our
integrative medicine doctor indicated that the vaccine was
administered over a larger area in  the  rib cage portion of the body 
and was used in Mexico.  And yes, I do need a rather reliable source
indicating that the rib cage area has been shown to be an effective
area for the BCG vaccine.  Best of luck on this search.

Dear dpage,

The closest thing I could find about this was an article in MEDLINE
from 1976:

Eur J Cancer. 1976 Mar;12(3):203-10.  

The effect of BCG on B16 mouse melanoma: a comparison of routes of
administration on tumour growth at different anatomical sites.

Proctor JW, Auclair BG, Lewis MG.

There wasn't an abstract available, but your doctor can probably get a
copy  for you through your local medical library, or you can order it
through PubMed: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=939237&dopt=Abstract
.

There were some other interesting articles on the subject of cancer
and the use of BCG.  I will list the links to other abstracts and
articles you might find helpful:

1) Ann N Y Acad Sci. 1976;277(00):160-86.   

Immunotherapy of cancer patients with Bacillus Calmette-Guerin:
summary of four years of experience in Japan.

Torisu M, Fukawa M, Nishimura M, Harasaki H, Kai S, Tanaka J.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1069547&dopt=Abstract
(link to the abstract)

This did not specifically mention melanoma or injecting in the ribs,
but did mention using many injections of BCG.

2) J Surg Oncol. 1977;9(6):587-93.  

Risks of BCG intralesional therapy: an experience with melanoma.

Robinson JC.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=145518&dopt=Abstract
 (link to the abstract)

This is about a man who had a near-fatal reaction to BCG but then was
cured of melanoma.  Interesting but a bit scary.

3) Expert Opinion on Biological Therapy 
2002, vol. 2, no. 3, pp. 335 - 342 
M-Vax: an autologous, hapten-modified vaccine for human cancer
David Berd 

http://gessler.ashley-pub.com/vl=8662968/cl=66/nw=1/rpsv/cgi-bin/linker?ini=ashley&reqidx=1471-2598(2002)L.335
 (link is to the abstract but copy can be ordered online)


4) J Immunother. 1999 Mar;22(2):166-74.  

Recombinant human granulocyte macrophage-colony stimulating factor
(rhGM-CSF) and autologous melanoma vaccine mediate tumor regression in
patients with metastatic melanoma.

Leong SP, Enders-Zohr P, Zhou YM, Stuntebeck S, Habib FA, Allen RE Jr,
Sagebiel RW, Glassberg AB, Lowenberg DW, Hayes FA.

Department of Surgery, University of California, San Francisco/Mount
Zion Cancer Center 94115, USA.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10093041&dopt=Abstract
 (link is to the abstract)

5) Am J Clin Oncol. 1991 Aug;14(4):291-7.  

Long-term evaluation of intrapleural bacillus Calmette-Guerin with or
without adjuvant chemotherapy in completely resected stages II and III
non-small-cell lung cancer.

Macchiarini P, Hardin M, Angeletti CA.

Service of Thoracic Surgery, University of Pisa, Italy.

This is not talking about melanoma, but it does mention "intrapleural
injections", which would be through the rib cage.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1650528&dopt=Abstract
 (link is to the abstract)

6) J Natl Cancer Inst. 1981 Oct;67(4):863-9.  

Mechanism of action of BCG-tumor cell vaccines in the generation of
systemic tumor immunity. II. Influence of the local inflammatory
response on immune reactivity.

Key ME, Hanna MG Jr.

Again, this mentions multiple injections as being more beneficial than
one.  It is referring to liver cancer, however.


I hope some of this is useful or helpful at all.  Good luck!