Blue Light Cystoscopy: An Innovation in Bladder Cancer Detection

Blue Light Cystoscopy — An Innovation in Bladder Cancer Detection An advancement in cancer detection, Blue Light Cystoscopy (BLC®) with Cysview® is a gamechanger for identifying and removing bladder tumors — and it is now available at Roswell Park.

Cystoscopy is a procedure that uses a cystoscope, a thin, lighted tube, passed through the urethra and into the bladder, allowing the physician to examine the bladder lining for any masses or abnormal lesions that could be cancer. Sometimes cancerous tissue can look similar to normal bladder tissue, and very small or early-stage cancers can be difficult to identify and remove completely, increasing risk for the cancer to recur or progress to a higher stage.

Blue light cystoscopy is a new technology that helps urologists differentiate cancerous tissue from normal tissue significantly better than standard cystoscopy. The procedure uses a liquid imaging agent with fluorescence, Cysview, that’s delivered through a catheter into a patient’s bladder about an hour before the procedure. Only the cancer cells retain the solution, causing them to appear an unmistakable, bright pink color when viewed with a specific wavelength of blue light. This enhanced visibility leads to increased tumor detection — and more effective tumor removal. An analysis of nine clinical studies found that blue light cystoscopy detected at least one additional tumor in nearly 25% of patients.

An estimated 79,000 people are diagnosed with bladder cancer in the United States each year, and for about 70% of them, the diagnosis is non-muscle invasive bladder cancer — a highly treatable type in which the tumor has not invaded the bladder’s muscle layer. Many of these patients will undergo a surgical procedure called transurethral resection of bladder

tumor (TURBT) to remove the tumors from the bladder’s lining during cystoscopy.

“Historically, the recurrence rate for this cancer type has been high, even after successful TURBT,” explains Khurshid Guru, MD, Chair of the Department of Urology and Director of Robotic Surgery. “Blue light cystoscopy helps us visualize very small clusters of cancer cells, not visible with standard white light, and remove all the cancer more effectively. This decreases the potential for recurrence or progression to more advanced disease.”

Studies showed that blue light cystoscopy was significantly better at detecting early-stage nonmuscle-invasive bladder cancer and early signs of recurrence. In addition, in about ten percent of cases, a patient’s urine test will show that cancer cells are present, but no tumor is visible during standard cystoscopy. Blue light cystoscopy highlights the areas that should be removed.

At Roswell Park blue light cystoscopy with Cysview is the new standard for all cystoscopies, including follow-up and surveillance of patients who have been treated for non-muscle invasive bladder cancer. Typically, patients undergo follow-up cystoscopies every three to nine months to monitor for cancer recurrence. Blue light cystoscopy will detect early changes in the bladder mucosa or lining, allowing for prompt intervention before the cancer progresses to muscle-invasive disease, and saving patients from more radical treatment such as removing the bladder and/or systemic chemotherapy.