To enhance a burgeoning bladder cancer program, the Department of Urology at Upstate Medical University offers Blue Light Cystoscopy (BLC) with Cysview, a method that has been proven to increase detection rates of certain forms of bladder cancer.
Cysview is a photoactivating solution that causes bladder tumors to fluoresce when absorbed. Using it with BLC allows urologic oncologists to detect cancers that might have gone unnoticed under standard white light. Bringing BLC with Cysview to Upstate was a priority for Joseph Jacob, MD, MCR, Chief of the Bladder Cancer Program in the Department of Urology and Assistant Professor of Urology at Upstate Medical University. He joined Upstate Urology in 2017, intent on using his fellowship training to help meet the need for bladder cancer care in Central New York. Part of that meant acquiring advanced technology to improve quality.
“High-level evidence from recent randomized trials showed BLC with Cysview has been proven to benefit patients,” Dr. Jacob says. “This technology has been shown to increase the rate of detection of carcinoma in situ, which is typically flat, often difficult to see and identify, and can progress to more aggressive types of bladder cancer. That higher detection rate is a huge deal for patients.”
Studies have also demonstrated higher detection rates of nonmuscle invasive papillary bladder cancer using BLC with Cysview compared with white light cystoscopy.
“Upstate Medical University invested in Blue Light Cystoscopy with Cysview based solely on a desire to improve quality for patients in Central New York. That makes me proud to be part of Upstate.”
— Joseph Jacob, MD, MCR, Chief of the Bladder Cancer Program in the Department of Urology and Assistant Professor of Urology at Upstate Medical University
Detection and Removal
Most patients with bladder cancer are candidates for BLC with Cysview due to the typically noninvasive nature of the disease, according to Dr. Jacob. Available at Upstate Cancer Center at Upstate University Hospital since March 2019, BLC with Cysview begins with the introduction of Cysview into the bladder via catheter. The medicine is left to coat the bladder for one hour.
“Cysview is full of molecules that can be absorbed by cells, and the cells can be activated with a certain wavelength of light,” Dr. Jacob says. “In the procedure room, I use a standard white-light camera that allows me to switch to blue light. Under that wavelength, cancers pop out in bright pink that’s quite obvious compared with normal bladder tissue.”
Treatment often takes place concurrent with BLC with Cysview, which can supplement transurethral resection of a bladder tumor, a common procedure for staging and removing bladder cancer. Removing the tumor may set the stage for intravesical therapy, such as immunotherapy or chemotherapy.
“The bladder is an imperfect sphere with areas that require careful scrutiny,” Dr. Jacob says. “Using only white light, we might miss some subtle, small or flat lesions, but BLC with Cysview helps prevent that. If we were to overlook a flat carcinoma in situ, for example, then we would miss the opportunity to provide immunotherapy, which is the treatment of choice for this type of cancer.”
For information about the Department of Urology at Upstate Medical University, visit upstate.edu/urology.