Patients with superficial bladder cancer are routinely treated with surgical removal of the cancer and adjuvant therapy to decrease the risk of recurrent cancer or progression to more invasive disease. Despite standard treatment, the majority of patients with superficial bladder cancer experience recurrence of their cancer. A number of approaches for treatment of superficial or recurrent superficial bladder cancer are under evaluation. One approach was photodynamic therapy, which combines a photosensitizer such as Photofrin® with red laser light to destroy cancer cells. The photosensitizer is injected into a vein, travels through the bloodstream, and is picked up and incorporated into cancer cells. When the laser is directed at the cancer, the photosensitizer in the cancer cell captures the light from the laser which kills the cell.
Physicians at West Virginia University have evaluated photodynamic therapy in 58 patients with resistant superficial bladder cancer (papillary and carcinoma in situ) and patients who could not receive local treatment with chemotherapy or Bacillus Calmette-Guérin (BCG) immunotherapy. They reported the results in the
Journal of Clinical Laser Medicine and Surgery.
With a single photodynamic treatment, 84% of patients with residual resistant papillary transitional cell carcinoma and 75% of patients with refractory carcinoma in situ experienced a complete response or disappearance of their cancer. Now, over 4 years from treatment, 59% of the patients responding to treatment are alive and 31 of 34 survive without cancer recurrence.
Photodynamic therapy was safe and effective treatment for refractory carcinoma in situ or recurrent papillary transitional cell carcinoma. Clinical trials are ongoing to determine whether this form of treatment is superior to standard BCG immunotherapy or chemotherapy. (Journal of Clinical Laser Medicine and Surgery, Vol16, No 1, pp 61-68, 1998)