Shedding new light on bladder cancer. It's not a device, but a dye that's helping doctors spot cancerous cells they may have missed with the naked eye. It's a simple addition to a standard test -- but it may make a significant difference when it comes to patient outcomes.
It was six years ago when Francis Cardinal George was diagnosed with cancer. Doctors removed his bladder, prostate and parts of his ureter. Just last week, a second diagnosis -- this time cancerous cells were found in his kidney and liver.
University of Chicago Medical Center: "Bladder cancer, when it does recur, most commonly recurs in the lymph nodes, lungs, liver and bone. Then we're talking about needing pretty powerful chemotherapy."
It's a chain of events doctors would like to derail. The process to stop bladder cancer in its tracks starts with a routine procedure called a cystoscopy.
Dr. Steinberg: "Cystoscopy is where we take a telescope, a small telescope through the patient's urethra and look inside the bladder."
A standard white light guides doctors' eyes to suspicious lesions but the procedure isn't perfect.
Dr. Steinberg: "The bladder is a three-dimensional organ and you've got to look around corners almost to see the entire bladder. There are times when we miss certain tumors; we just don't see them well. We know that because the routine today is to repeat the cystoscopy and biopsy of the bladder six weeks after the previous one and we pick up new tumors about 30-40% of the time. I don't think those are tumors that are new. It's tumors that we missed during the initial evaluation and diagnosis."
That's why University of Chicago Urologic Oncologist Gary Steinberg was eager to try Cysview -- a new contrast dye that contains a special protein that sticks to cancer cells like glue. It's injected into the bladder using a cystoscope armed with a blue light -- when doctors switch it on, the cancer cells glow.
Dr. Steinberg: "A big neon sign saying here I am and it just sounds so simple but that really helps make it easier."
Sixty-nine-year-old Pat Kelly underwent blue-light cystoscopy after noticing blood in his urine. This is video taken during his first procedure. The scope makes its way to the bladder -- on the right, an obvious mass. When doctors switch on the blue light -- a sea of neon pink lights up, expanding well beyond the tumor.
Dr. Steinberg: "I think that you can spend a lot of time and look very, very carefully with the white light and potentially find the majority of the tumors. There's no question that you can do it easier with the blue light."
A second procedure also utilizing Cysview -- yielded more cancerous cells in Pat's bladder.
Dr. Steinberg: "We were able to trim out everything that was red."
Pat Kelly: "I'm very grateful that I'm one of the early guinea pigs at this institution for having that procedure."
Now this grandfather can focus on his family -- and a few other pursuits.
Pat: "I feel great. I was golfing yesterday morning."
But for patients like Cardinal George, whose cancers have spread, there will be many more rounds of treatment. Dr Steinberg believes if blue light cystoscopy had been available at the time of his original diagnosis -- it may have changed the outcome.
Dr. Steinberg: "It's possible that Cardinal George's tumor and his carcinoma in situ may have been detected earlier and that had it been detected earlier and been treated earlier that he would have been cancer free beyond the six years and hopefully would have been cancer free a lifetime."
Cysview seems to have fewer side effects than older photodynamic agents used to enhance tumor detection, some of which caused a lot of photosensitivity, leaving patients unable to go in the sun. To learn more about Dr. Gary Steinberg and blue-light cystoscopy, check out http://www.uchospitals.edu/physicians/gary-steinberg.html
New tool helps better detect bladder cancer
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