Upstate’s New Imaging Technology Improves Bladder Cancer Detection

By Payne Horning

Upstate University Hospital has introduced a new way to discover bladder cancer that officials hope will light the way to improved results for patients.

Blue light cystoscopy is a technology that involves the use of a special fluorescing agent, which is directly injected into a patient’s bladder ahead of an operation. Cancer tumors soak up this material, causing them to emit a bright pink glow. Doctors can then better spot where the tumors are thanks to the pink color’s sharp contrast with the blue-screen lens.

Physician Joseph Jacob, a fellowship-trained urologic oncologist who directs the bladder cancer program at Upstate, says this new technology is a game-changer.

“It makes it much easier for us to see — especially small tumors — the ones that are flat and may not be obvious,” Jacob said. “If you can pick these up, you can clean up the bladder, you can be more confident that you’re doing a better job for the patient, and what that means is we’re not missing tumors that could lead to dangerous effects for the patient.”

Jacob says the technology is so easy to use that finding where the cancerous cells is obvious, something even a layperson with no medical training could find.

“It’s not even really a subtle thing — it lights up,” he says “I use it on all of my bladder cancer patients. We’re picking up more instances than before. It’s helping me tremendously.”

Jacob says there are no side effects from the fluorescing agent either apart from very rare allergic reactions.

The key to the success of this new approach, according to Jacob, is that cancerous cells in the bladder don’t function like their healthy counterparts. The normal lining of the bladder is built to not absorb any fluids. The tumors, on the other hand, are growing and have more blood flow through them — opening the door to the fluorescing agent.    

Blue light cystoscopy has seen great success in national trials as well, Jacob says. Doctors are finding more cancers, keeping patients out of the operating room longer, and preventing cancers from returning as frequently as they were before. The American Urological Association and the Society of Urologic Oncology recommended the technology in its 2016 guidelines because it can improve detection of cancerous cells.

Jacob says most of the major cancer centers in the country now offer Blue light cystoscopy, but its reach elsewhere is limited.

“It’s money. Money talks,” Jacob says. “We [at Upstate] are academics and so we’re always trying to think of what we can do that’s evidence-based that can improve care for patients. That’s something we’re always trying to do. This is evidence-based — it’s been shown to help patients and so we just made it a priority.”

According to Upstate, bladder cancer affects more men than women and the likelihood of bladder cancer increases with age. About nine out of 10 people with bladder cancer are older than 55, while the average age of diagnosis is 73.