Science Video

Shedding Light on Bladder Cancer
Urologists Use Optics, Chemistry to Catch Small Tumors

October 1, 2005 — Some bladder cancer tumors are so small, surgeons can't see them. Urologist Edward Messing is using a new liquid dye that reacts to light to help him see all the small bladder tumors that might have been missed in conventional biopsies.

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ROCHESTER, N.Y.--The earlier the better, when it comes to detecting cancer. Now, doctors are shedding new light on detecting the deadly disease. Currently, 400-000 people suffer from it while 60,000 more will find out they have it, and bladder cancer usually strikes more than once.

Larry Sylvan, a cancer survivor, says, "At nine months it was back." He knows what it's like to battle bladder cancer. Sylvan's doctor, Edward Messing, says, "The surgery was successful; I got everything I could see." The doctor's key word -- see; some bladder cancer tumors are so small, surgeons can't see them.

Dr. Messing, a urologist at the James P. Wilmot Cancer Center in Rochester, N.Y., says, "Before it was sort of blind guessing." A new photo-sensitizer, a liquid dye inserted into the bladder, improves detection of those small tumors. Under ordinary light, everything looks fine, but when the florescent light is turned on, the entire background looks blue, except where the tumor is -- that shows up bright red.

Jerry Gulette was one of the first patients to use the dye. He's battled bladder cancer time and time again. Dr. Messing says, "I had seen maybe four, five tumors when I cystoscoped him with the white light. And when we turned on this pink light there were 12 or 13."

More than 94 percent of the people diagnosed with bladder cancer will survive it if it's caught in the early stages. That's why this new procedure is so critical for those diagnosed.

BACKGROUND: Urologists use a liquid dye to more easily find tiny cancers in the bladder that could grow after surgery.

HOW THE LIQUID DYE HELPS: The liquid dye helps identify all the tiny tumors in the bladder that can remain after a major surgery is done. The dye, called a photosensitizer, reacts with light to make the cancerous tissue look bright red during an examination. The photosensitizer even detects a rare form of bladder cancer that is hard to detect because it lies almost flush against the walls of the bladder.

HOW THE BLADDER WORKS: The bladder stores urine, which is produced when the kidneys filter urea, a waste product of proteins, from the blood. The bladder is a hollow organ made of muscle, connected to the kidneys by the ureters, and empties through the urethra. Adults eliminate about a quart and a half of urine each day. The amount depends on many factors, especially the amounts of fluid and food a person consumes and how much fluid is lost through sweat and breathing.

WHAT IS BLADDER CANCER? About 90 percent of bladder cancers begin in the cells lining the bladder. Cancer that is confined to the lining of the bladder is called superficial bladder cancer and is sometimes removed by scraping away the cancerous cells with a small wire loop.

In some cases, cancer that begins in the transitional cells spreads through the lining of the bladder and invades the muscular wall of the bladder. This is known as invasive bladder cancer. Invasive cancer may grow through the bladder wall and spread to nearby organs.

To register for clinical trials in your area call:
Cancer Information Service
1-800-4-CANCER (1-800-422-6237)
TTY at 1-800-332-8615

Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.

Note: This story and accompanying video were originally produced for the American Institute of Physics series Discoveries and Breakthroughs in Science by Ivanhoe Broadcast News and are protected by copyright law. All rights reserved.