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SAN ANTONIO
MEDICINE

Impacting Recurrence in Non-Muscle

Invasive Bladder Cancer

Announcement by University of Texas Health Science Center San Antonio

In the United States, more than 720,000 people approved optical imaging agent indicated for use in
are living with bladder cancer, and an estimated the cystoscopic detection of NMIBC including CIS
1
83,730 people will be diagnosed this year. Mays among patients suspected or known to have lesion(s)
Cancer Center at UT Health San Antonio is now based on a prior cystoscopy or undergoing surveil-
offering Blue Light Cystoscopy with Cysview® for lance cystoscopy for carcinoma of the bladder.
improved detection and management of non-muscle Cysview is instilled in the patient’s bladder at least
invasive bladder cancer (NMIBC), including carci- one hour before the procedure and used with the
noma in situ (CIS) in an outpatient setting. KARL STORZ Photodynamic Diagnostic system
“Treatment of bladder cancer requires careful, to perform Blue Light Cystoscopy as an adjunct to
Bladder image from White meticulous detail and adherence to surveillance White Light Cystoscopy.
4
Light Cystoscopy regimens,” said Dr. Robert Svatek, Urologic On- “Expertise in the management of advanced bladder
cologist at Mays Cancer Center and Chair of Urol- cancer requires proper timing and coordination of
ogy at UT Health San Antonio. “It requires multiple treatment modalities available to treat the
diligence in the administration of proper standard- disease including surgery, radiation therapy and
ized therapy, but treatment regimens must also be chemotherapy.” To that end, Dr. Svatek has developed
individualized.” a collaborative care pathway that provides exceptional
Cystoscopy is the gold standard diagnostic tool for precision in the pre-operative and post-operative
bladder cancer. Historically, this has been conducted management of patients with bladder cancer.
using white light cystoscopy; however, some tumors

2,3
may escape detection under white light alone. To References:
increase detection and decrease recurrence for pa- 1. National Cancer Institute. SEER Stat Facts: Bladder Can-
Same Image from Blue Light tients suffering from bladder cancer, Blue Light Cys- cer 2017. https://seer.cancer.gov/statfacts/html/
Cystoscopy with /Cysview toscopy with Cysview is employed. urinb.html. Accessed January 25, 2019.
“Although it is not a replacement for biopsy, Blue 2. Hermann GG, Mogensen K, Carlsson S, Marcussen N,
Light Cystoscopy with Cysview is an enhanced cys- Duun S. Fluorescence-Guided Transurethral Resection of
toscopy that helps us identify lesions that may not be Bladder Tumours Reduces Bladder Tumour Recurrence
visible using white light cystoscopy alone,” said Dr. Due to Less Residual Tumour Tissue in Ta/T1 Patients:
Svatek. “This advanced approach helps us elevate our A Randomized Two-Centre Study. BJU Int.
2011;108(8b):E297-E303.
diagnostic capabilities and provide a higher standard
3. Daneshmand S et al. Efficacy and safety of blue light flex-
of care for our patients.”
ible cystoscopy with Hexaminolevulinate (HAL) in the
During a standard cystoscopy procedure, the blad-
surveillance of bladder cancer: A phase III, comparative,
der is examined using white light. During a Blue
multi-center study. J Urol. 2017 Dec 2.
Light Cystoscopy with Cysview, both white and blue 4. Cysview [prescribing information]. 2018:1-14. Chang SS,
light are used. Cysview makes tumor cells glow Boorjian SA, Chou R, et al. Diagnosis and Treatment of
bright pink in blue light, but it is not a dye. It is a Non-Muscle Invasive Bladder Cancer: AUA/SUO Guide-
hexyl-ester of aminolevulinic acid that results in an line. J Urol. 2016;196(4):1021-1029.
increased volume of porphyrins in cells. Unhealthy
cells do not process out the porphyrins as quickly as Mays Cancer Center is the first and only center in
healthy cells; the resulting accumulation creates a the region to offer Blue Light Cystoscopy with Cysview®
pink glow in blue light. in an outpatient setting for improved detection and
Cysview® (hexaminolevulinate HCl) is an FDA- management of non-muscle invasive bladder cancer.

38 SAN ANTONIO MEDICINE • July 2021