New technology adopted to improve bladder cancer detection

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New technology available at the Keck Medical Center of USC helps urologists identify more bladder tumors, according to Sia Daneshmand, director of urologic oncology at the USC Institute of Urology. (Photo/Courtesy of Keck School)
New technology available at the Keck Medical Center of USC helps urologists identify more bladder tumors, according to Sia Daneshmand, director of urologic oncology at the USC Institute of Urology. (Photo/Courtesy of Keck School)

The Keck Medical Center of USC is the only health care provider in the western United States to offer blue light cystoscopy, a new diagnostic tool for bladder cancer. The technology helps urologists identify more bladder tumors that are difficult to see using conventional white light cystoscopy.

“In the United States, bladder cancer is the fourth most common cancer in men and the most expensive cancer to treat,” said Sia Daneshmand, director of urologic oncology at the USC Institute of Urology and associate professor of urology at USC. “This new technology makes it much easier to see tumors that previously would have gone undetected. The more cancer that we can remove at earlier stages, the lower the chance of recurrence.”

The most common symptom of bladder cancer is blood in the urine, which typically calls for a urine analysis that detects presence of cancer and white light cystoscopy.

“The traditional white light cystoscopy is a minimally invasive procedure that allows the doctor to see inside the bladder,” said Anne Schuckman, director of urologic oncology at Los Angeles County+USC Medical Center and assistant professor of urology at USC. “Anything abnormal is biopsied and/or removed, but certain tumors can be invisible and may be missed when using white light cystoscopy alone.”

Cysview (hexaminolevulinate HCl) is an optical imaging agent that accumulates in tumor cells of the bladder and glows pink under blue light, making them easily discernible from healthy bladder tissue. It is designed to detect papillary cancer of the bladder in patients with known or suspected bladder cancer based on routine white light cystoscopy

The solution, marketed as Hexvix in Europe and approved by the U.S. Food and Drug Administration in 2010, is used with the Karl Storz Photodynamic Diagnostic D-Light C system, which includes both white and blue light cystoscopy settings.

In clinical trials, blue light cystoscopy using Cysview found additional tumors in nearly 16 percent of patients when compared to using white light alone.

“Bladder cancer is difficult to detect, even for specialists,” said Inderbir Gill, founding executive director of the USC Institute of Urology and associate dean of clinical innovation at the Keck School of Medicine of USC. “Patients with known or suspected bladder cancer can now come to the Keck Medical Center of USC and take comfort in the fact that their doctors are trained and experienced in using the most advanced diagnostic technology available.”

The National Cancer Institute estimates that more than 72,500 new cases of bladder cancer will be diagnosed this year, while roughly 15,200 people will die from the disease. Bladder cancer has a recurrence rate of up to 80 percent and requires lifelong surveillance after diagnosis, making it the most expensive cancer to treat on a per-patient basis, according to the Bladder Cancer Advocacy Network.

“Providing advanced, high-quality patient care is a critical component of our Keck Medical Center of USC mission,” said Scott Evans, CEO of the USC hospitals. “We pride ourselves on innovation and collaboration. Our doctors and staff are always looking for new ways to heal patients. The blue light cystoscopy is a prime example of our commitment to returning patients to their normal routines as quickly as possible.”

Blue light cystoscopy is performed at the Keck Medical Center as an outpatient procedure and is covered by most major insurance providers. It is sometimes followed by a course of chemo- or immunotherapy instilled in the bladder to prevent recurrence. Cysview is not recommended for use in patients with porphyria or sensitivity to hexaminolevulinate. (Alison Trinidad/ University of Southern California)