RE:RE:RE:TRUTHSL sorry about your friends situation. I feel in this case refractory means the side effects are such that the MD thinks it to dangerous to continue w BCG. Side effects are common with BCG because it is an attenuated live bacteria. Obvious it worked as the cancer has be arrested. MCNA is a denatured piece of cell wall from M phlei which is a harmless bacteria unlike BCG. MCNA directly stimulates the immune system as well as directly killing the cancer cells. It has very very few non life threatening side effects. If it was me I would be trying to obtain MCNA on a scheduled basis say X amount of times every year as recommended by a urologist. Good Luck