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DIABETES MEDICATION “ACTOS” LEADS TO HIGHER RISK OF BLADDER CANCER
YOU MAY BE ENTITLED TO FINANCIAL COMPENSATION & NON-INVASIVE TREATMENT
Transitional cell carcinoma shows up in the cells that line the inside of the bladder. These cells have been shown to expand when the bladder is full, then contract when the bladder is empty. In addition to being the dominant cell type in the lining of the bladder, transitional cells line the inside of the ureters and urethra—sites where tumors can form as well.
About 70% of transitional cell carcinomas of the bladder are superficial, i.e., at or close to the surface of the bladder lining. Despite complete tumor removal via surgery, at least two out of every three patients who undergo the procedure called transurethral resection (TUR) will experience a recurrence. A number of these cases (about 15%) will progress to become muscle-invasive tumors, a more aggressive form of cancer.
Bremachlorin-based photodynamic therapy (PDT) is a safe, effective treatment for invaisive bladder cancer, especially in cases for which conventional treatments had failed. We also explored some of the ways in which photodynmaic diagnosis (PDD) could play a key role in the detection and management of bladder cancer.
What makes bladder cancer such a great candidate for light-based strategies such as PDT and PDD? The simplest answer is the organ’s easy access for both photodynamic diagnosis and treatment. This is particularly the case with the type of bladder cancer known as transitional cell carcinoma, the most common type of bladder cancer in Europe and the United States.
To what do we attribute this high recurrence rate? The main explanation has been the relatively poor visibility of cancerous tissue, which may tend to be overlooked during the TUR procedure mentioned above. Logically, this could lead to a recurrence. With the help of PDD, however, it may be possible to carry out TUR in a more effective way.
Photomedical Imperatives
Medical research has long sought a practical way to improve the recognition of malignant tumors in and around the bladder. In 1992, one such clinically applicable procedure was introduced: PDD with the help of the photosensitizer known as 5-aminolevulinic acid (5-ALA). The 5-ALA is administered prior to the PDD, and this has been shown to greatly improve the detection of flat, small papillary and remnant bladder lesions that are barely visible under conventional white light.
Nevertheless, there is now a fairly strong consensus among PDD researchers that the recurrence rate can be reduced by photodynamic methods. This is extremely important, given that superficial bladder cancer results in immense medical costs due to its persistently recurring, life-long character.
By reducing the frequency of recurrences, PDD could greatly reduce the recurrence rate and thus ease the medical-economic burden. On the other hand, as PDD is related to specific expenditures its use may not be justified on a larger scale but in those patients with obvious benefit from PDD only.
Sources
Gakis G, Ngamsri T, Rausch S, Mischinger J, Todenhöfer T, Schwentner C, Schmid MA, Hassan FA, Renninger M, Stenzl A. Fluorescence-guided bladder tumour resection: impact on survival after radical cystectomy. World J Urol. 2015 Jan 17. [Epub ahead of print]
Rouprêt M, Malavaud B, Molinier L, Leleu H, Blachier M, Marteau F. Cost-effectiveness of transurethral resection of the bladder with blue light in patients with non muscle invasive bladder cancer in France. Prog Urol. 2015 Jan 17. [Epub ahead of print, article in French]
Nakai Y, Anai S, Onishi S, Masaomi K, Tatsumi Y, Miyake M, Chihara Y, Tanaka N, Hirao Y, Fujimoto K. Protoporphyrin IX induced by 5-aminolevulinic acid in bladder cancer cells in voided urine can be extracorporeally quantified using a spectrophotometer. Photodiagnosis Photodyn Ther. 2015 Jan 13. [Epub ahead of print]
Baglo Y, Peng Q, Hagen L, Berg K, Høgset A, Drabløs F, Gederaas OA. Studies of the photosensitizer disulfonated meso-tetraphenyl chlorin in an orthotopic rat bladder tumor model. Photodiagnosis Photodyn Ther. 2015 Jan 6. [Epub ahead of print]
Aboumarzouk O, Valentine R, Buist R, Ahmad S, Nabi G, Eljamel S, Moseley H, Kata SG. Laser-induced autofluorescence spectroscopy: can it be of importance in detection of bladder lesions? Photodiagnosis Photodyn Ther. 2015 Jan 2. [Epub ahead of print]
