Blue Light Cystoscopy with Cysview

Each year, more than 80,000 people in the U.S. face a bladder cancer diagnosis. While about 70% of bladder cancers are diagnosed early, many are missed because of the difficulty in distinguishing these tumors from healthy tissue.

At The University of Kansas Cancer Center, our urologic oncology surgeons use Blue Light Cystoscopy™ with Cysview^® to better diagnose, evaluate and remove bladder cancer tumors and lesions. As a result of positive outcomes in clinical trials, the technology is included in the bladder cancer guidelines published by the American Urological Association and the Society of Urologic Oncology.

Our board-certified, fellowship-trained bladder cancer experts specialize in bladder disease diagnosis and offer the most advanced technologies and techniques available in the Kansas City region. Blue Light Cystoscopy with Cysview is an important tool that can aid in the diagnosis and treatment of bladder cancer.

Early and accurate diagnosis is essential to determining the best treatment for your type and stage of bladder cancer. Because of the proficiency of our bladder cancer team, our specialists can define the precise features of a tumor so that we can create a personalized treatment plan for each person.

Our urologic oncologists are the only ones in the region offering this advanced technology.

In the earliest stages of bladder cancer, cancer cells are located on the surface layer of the bladder wall. Identifying this kind of cancer, which is called nonmuscle invasive bladder cancer, requires a correct and thorough workup, and diagnosis is a key component of successful treatment. Understanding the stage and grade of the cancer is essential to deciding on the best treatment path.

To diagnose this disease, surgeons inspect the inside of the bladder using a long, thin tube called a cystoscope that includes a video camera on the end. In the past, the only option was white light cystoscopes, which do not always easily show tumors or cancerous lesions.

BLC with Cysview uses a cystoscope equipped with both white and blue light for visual inspection inside the bladder. A small amount (less than 2 ounces) of the prescription imaging agent Cysview is placed into the bladder using a catheter before the procedure. Together, the medication and device are able to detect significantly more bladder cancer in more patients.

BLC with Cysview has been used in more than 450,000 patients. It was approved in the U.S. in 2010 and was included in the American Urological Association and Society of Urologic Oncology guidelines for the management of patients with nonmuscle invasive bladder cancer in 2016. More than 120 centers in the U.S. use BLC with Cysview.

Anyone who is suspected of having or known to have bladder cancer (from a previous cystoscopy) can have BLC with Cysview. As with all medical situations, your physician will work with you to determine if Cysview is right for your situation.

BLC may be appropriate for the following:

• When a biopsy or white light cystoscopy inspection detects early-stage bladder cancer
• As a follow-up to BCG bladder cancer treatment
• If multiple low-grade tumors are present
• For re-evaluation 4 to 6 weeks after tumor removal
• If bloodwork indicates presence of cancer cells and white light cystoscopy is negative
• In assessing bladder cancer tumors

When symptoms and blood tests suggest that a patient has bladder cancer, physicians visually inspect the interior wall of the bladder using a cystoscope — a thin tube with a light and video camera on the end — in a procedure called a cystoscopy.

While larger nonmuscle invasive bladder cancer tumors may be visible using white light, smaller cancerous areas may not be easily detected because their color can resemble surrounding healthy tissue.

With BLC, physicians use a cystoscope equipped with both white and blue light and administer an optical-imaging drug called Cysview (hexaminolevulinate HCl) that is absorbed by cancer cells. Cysview makes the cancer cells glow bright fluorescent pink in blue light and stand out against the blue of the healthy tissue. This results in improved visualization and detection of nonmuscle invasive bladder cancer lesions. Studies show there is a significant increase in the detection of nonmuscle invasive bladder cancer using this advanced technology.

Blue Light Cystoscopy with Cysview is not suitable for all types of bladder cancer. Bladder cancer falls into 2 general categories:

• Nonmuscle invasive bladder cancer: About 70% of all bladder cancers fall into this category, in which a tumor (also called a lesion) is still in the inner layer of cells of the bladder’s inside wall.
• Muscle invasive bladder cancer: This disease, which is less common than nonmuscle invasive, occurs when the cancer has grown into deeper layers of the bladder wall. This disease is more likely to spread to other organs and is more difficult to treat.

Cysview readily detects NMIBC, which may be hard to distinguish from healthy tissue. Due to its more advanced nature, MIBC tumors are detected through white light cystoscopy, biopsies, manual exam, imaging and other diagnostic tests.

BLC with Cysview works better than white light alone. Because Cysview causes bladder cancer cells to glow bright fluorescent pink in blue light, surgeons are better able to see smaller tumors and flat lesions that may not be seen with white light. The surgeon can immediately remove diseased tissue, ideally leaving a clean margin of healthy tissue around the resection site. Cysview gives urologic surgeons the ability to better evaluate, identify and remove hard-to-see tumors more accurately.

By seeing more lesions, the stage and grade of the tumor can be more accurately determined and appropriate management and treatment offered.

Cysview is not a replacement for random biopsies, which still need to be done to check whether there is any disease that has not been detected under white or blue light during the cystoscopic examination.

Shortly before your procedure, the Cysview solution is placed in the bladder via a catheter. About an hour later, the urologist begins the cytoscopy procedure, examining the bladder under white light and looking for anything suspicious. After that, it switches to the blue light. The Cysview solution causes tumors to glow a bright pink color, making it much easier for the urologist to remove affected areas.

Surgeons require special training to use Cysview and the cystoscope that has both white and blue light. The University of Kansas Cancer Center is among a select number of organizations around the country and the only one in the region using this approach, which is supported by the American Urological Association and the Society of Urologic Oncology.