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approximately 80,000 new cases of bladder cancer were diagnosed in the United States in 2019 with nearly 18,000 patients dying from bladder cancer.
It is the sixth-most common cancer in the country. Seventy five percent of bladder cancers are superficial or non-muscle invasive at the time of diagnosis. The remaining 25% are invasive into the deeper muscular layers of the bladder wall or have spread to other parts of the body. Risk factors for developing bladder cancer include smoking, certain occupational or environmental exposures prior radiation and male gender.
The most common presenting sign of bladder cancer is blood in the urine. Sometimes the blood is visible in the urine whereas other times blood in the urine is only noted on microscopic examination, and a person cannot see it.
Symptoms of bladder cancer can be similar to the symptoms seen with a urinary tract infection: burning with urination, frequent urination and urinary urgency.
In advanced cases, patients may have back or side pain from the kidneys being blocked by the bladder tumor, weight loss, bone pain or even skin discoloration.
The main way to diagnose bladder cancer is cystoscopy. A scope, the size of a small catheter, is inserted into the urethra and bladder. During this process, the bladder is gently stretched with fluid. This is routinely done in the office setting in a brief amount of time. Cystoscopy is performed under regular white light, the same type of lighting we see everyday from LED or incandescent bulbs.
A recent major advance in the diagnosis and treatment of bladder cancer is Blue Light Cystoscopy, or Cysview.
With this procedure, Cysview (Hexaminolevulinate) is placed directly into the bladder 60 minutes before the physician performs cystoscopy.
Cysview is absorbed by the cancer cells, and these cells will glow bright pink when seen under the blue light. This enables the physician to see some tumors that would not ordinarily be seen under regular white light. Some studies estimate 20% of bladder tumors will be missed with traditional white light alone.
Utilization of Cysview also gives the surgeon visual cues when removing the tumors through the endoscope that no tumor cells are left behind. When the surgeon resects the tumor, the surgeon makes sure there are no remaining areas that fluoresce while the patient is still in the operating room, thus increasing the likelihood that all the cancerous tissue has been removed.
Several studies have reported the benefits of Cysview. Some of these benefits include decreased chance of cancer returning and possibly reduced risks for cancer worsening or progression.
Ultimately, the patients who have cancer advance from the more superficial layers of the bladder to the deeper layers have a higher risk of the cancer spreading to other areas and dying from bladder cancer. Therefore, any technology that increases the odds of cancer detection and also decreases the chances of cancer returning or cancer growing deeper into the bladder is beneficial.
The National Comprehensive Cancer Network has recognized the benefits of Cysview and has added it to the most recent bladder cancer guidelines.
In Northwest Indiana, we are pleased to offer this technology to our patients. Patients used to have to travel to large cities or to university medical centers to have access to this treatment. We have this technology here at home.
Cysview is one of the best new tools in our fight against bladder cancer.
Learn more about Urologic Specialists of Northwest Indiana at www.urologic-specialists.com.
