Washington University urologists at Barnes-Jewish Hospital use Blue Light Cystoscopy (BLC™) with Cysview® for detection of bladder cancer, which detects occult tumors that are often missed by standard white light cystoscopy. Bladder cancer is the fifth most common cancer for both sexes, with 81,000 cases and 17,000 deaths per year. About 50 to 80 percent of patients have recurrences.
“If that high a percentage of patients have recurrences, we must ask if it is because of a mutation or instability in the lining of the bladder, or if it is actually missed tumors that aren’t seen on the initial cystoscopy and then go on to grow?” adds urologist Zachary Smith. “If it’s the latter, this diagnostic tool will decrease that recurrence.”
Before the procedure, the imaging drug Cysview® is instilled in the bladder. Cysview® penetrates the cellular membrane of cancer cells, and enzymes metabolize the drug, leading to an accumulation of protoporphyrin IX (PpIX). With levels of PpIX up to 10 times greater in neoplastic cells, the blue fluorescence causes cancers cells to glow in a light pink color.
Phase III studies using BLC™ and Cysview® demonstrated statistically significant improvement in the detection of papillary tumors and carcinoma in-situ, as well as a significant reduction in recurrence rates.
“Ultimately, patients win here because they undergo fewer procedures and biopsies since we find the tumors all at one time,” says Smith.