Fluorescence diagnosis of bladder cancer

Standard management of newly presenting superficial bladder tumours is to remove the tumour endoscopically and to administer a single dose of a chemotherapeutic agent into the bladder postoperatively. However, between 20-40% of patients will develop a tumour in the bladder again within 12 months (Herr, 1997). There is controversy about whether these tumours are genuine recurrences or previously undetected tumours. Photodynamic diagnosis is currently the subject of clinical trials for detection and surveillance of bladder cancer. A solution is administered into the bladder preoperatively which is absorbed by the cancer cells. These areas within the bladder then fluoresce under blue light, aiding the surgeon to detect tumours that may not have been visible to the naked eye. The authors present a review of this developing technique and their early experiences of photodynamic diagnosis in clinical trials which appear to be clinically relevant in decreasing recurrent bladder tumours.