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Lighting Up Cancer Cells

June 27, 2013

Two urologic surgeons at Vanderbilt-Ingram Cancer Center are among a leading group of cancer physicians using an innovative new imaging agent and blue light system to “light up” cancerous cells inside the bladder.

The combined system is used to confirm non-invasive papillary cancer inside the bladder and help surgeons detect and remove more of the cancerous tumors.

Sam S. Chang, M.D., and Michael S. Cookson, M.D., both professors of Urologic Surgery, participated in the pivotal clinical research trials for Cysview—an imaging agent which attaches to tumor cells and fluoresces a bright pink color when used with a special camera and lighting system. The new technology has been shown to enhance detection and treatment of bladder cancer.

Using the new system, physicians insert the liquid Cysview optical agent into the bladder for 50-60 minutes prior to the surgery.

“It coats the inside of the bladder and both normal bladder cells and the cancer cells are exposed to the liquid,” said Chang, who serves as chairman of the American Urological Association’s Guidelines on Bladder Cancer. “The tumor or malignant cells preferentially absorb more of this agent and it fluoresces.”

When surgeons switch on a special blue light, the tumors glow pink, making it easier to confirm the presence of some tumors. Physicians can switch back and forth between the white and blue lights during surgery to remove the cancerous cells.

“In white light you think you’ve removed all of the tumor but you turn on the blue light and you can still see outlines of pink so you go wider,” explained Chang.

Vanderbilt has been named one of 10 Centers of Excellence in the United States for the use of the new technology and patients with hard-to-detect forms of bladder cancer are now being referred to VICC.

“In the types of patients that are referred to us, the ones that are difficult to diagnose, that recur very frequently, this is a very nice option to have because you feel very confident that you’ve not only seen the tumors but you’ve been able to treat them,” said Chang.

Cookson, the Patricia and Rodes Hart Professor of Urologic Surgery, said clinical trials with the new system demonstrated its value.

“Tumor detection improved about 16 percent and then subsequent studies showed about the same reduction in recurrence rates. It’s more than just helping them find the tumors but it can also lead to reduced need for subsequent surgeries.”

– by Dagny Stuart