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New procedure makes targeting, eliminating bladder cancer easier

Fluorescent cystoscopy has increased bladder cancer detection rates by 20 to 25 percent.
University of Minnesota Health Urologic Surgeon Badrinath Konety, MD, believes a new procedure called fluorescent cystoscopy will make it easier for physicians to find and remove bladder cancer.
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A new procedure is allowing University of Minnesota Health surgeons to easily find and more accurately eradicate cancerous cells in the bladder.

The procedure, known as a fluorescent cystoscopy, has increased bladder cancer detection rates by 20-25 percent, according to Badrinath Konety, MD, a urologic surgeon and the director for the Institute for Prostate and Urologic Cancers.

Typically, physicians place a cystoscope in a patient’s bladder and use a white light to search for the telltale signs of tumors on the bladder walls. But the cancer can easily blend into the background, making it difficult to find, Konety said.

During a fluorescent cystoscopy, also known as a photodynamic diagnosis, physicians inject a chemical into the patient’s bladder prior to the exam. The chemical is only absorbed by cancerous cells in the bladder. The physician then uses a cystoscope equipped with a blue light to conduct the cystoscopy. The cancerous cells, marked by the chemical solution, glow red under the blue light, allowing physicians to easily detect and measure the growth of the cancer.

Bladder cancer is the fourth most common cancer among men in the United States, and one of the top ten most common cancers for women in the United States, Konety said.

“Fluorescent cystoscopy allows us to identify the bladder cancer much better and sometimes find cancers where none were previously seen using a regular white light,” Konety said. “This also allows us to better treat their cancers by more completely removing the cancer at the time of the biopsy or resection.”

The innovative procedure spared one University of Minnesota Health patient from a full bladder removal. Tom, who was diagnosed with bladder cancer in 2012, was scheduled for a radical cystectomy, in which doctors remove the bladder, plus surrounding lymph nodes and tissue, in an effort to eliminate cancer.

But Tom underwent a fluorescent cystoscopy as part of a clinical trial before the surgery, and doctors “cleaned out” as much of the cancer as they could find using a less radical technique. When it came time for Tom’s scheduled surgery, doctors couldn’t find any cancer remaining in his bladder, and spared the organ.

“I attribute that [fluorescent cystoscopy] light to them getting all the cancer,” Tom said. “I got to save my bladder.”

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