Precision diagnostics & bladder cancer
Bladder Cancer is characterized by high recurrence rates and requires long-term, often life-long, surveillance. The bladder cancer journey involves repeated cystoscopies and transurethral resection of bladder tumors (TURBTs) to detect recurrence and avoid or delay progression to muscle invasive bladder cancer that typically involves cystectomy and more comprehensive cancer treatments, often including systemic (whole body) drug therapies and radiation.
Why is Non-Muscle Invasive Bladder Cancer (NMIBC) drawing focus in urologic oncology and personalized cancer therapies?
Bladder cancer exhibits significant genetic diversity, influencing its development, progression, and response to treatment. As a result, bladder cancer is characterized by a variable prognosis1 which has not improved in decades. The management of NMIBC requires precise surveillance, repeated interventions, and patient-tailored therapies to balance treatment efficacy with quality of life and cost burden.2
Bladder cancer primarily affects older adults, especially men over 65, with rising incidence linked to an increasingly elderly population, smoking and occupational exposures. Though rare in younger adults, cases do occur and are usually low-grade, non-invasive tumors. The rising incidence of bladder cancer-particularly among older adults, smokers, and populations with occupational exposure.
Precision medicine requires precision diagnostics
The early identification of patients with bladder cancer and the accuracy of the diagnosis are crucial for improving patient management and outcome, especially in an era of precision medicine. In the ongoing shift towards less invasive and more personalized treatment in bladder cancer, several new therapies have received market approval for bladder cancer. The role of diagnostics is to ensure the right patients are identified and monitored to ensure efficient therapy.
In response to the development of precision medicine, there is an accompanying rapidly evolving area of precision diagnostics for bladder cancer. Digital pathology and cytology, advanced radiology, biomarkers and liquid biopsy, artificial intelligence and other technologies have been developed to diagnose, predict outcomes and tailor treatments in bladder cancer. The use of both old and new diagnostic technologies, perpetually rely on cystoscopy to assist in a definitive diagnosis by providing the necessary visualization of lesions and allow for biopsies and pathological assessment.
In this context, enhanced cystoscopy is as relevant as ever before. Photocure’s diagnostic product is used within blue light cystoscopy as adjunct to standard white light cystoscopy to contribute to the diagnosis and management of bladder cancer in patients with known or high suspicion of bladder cancer.
It is known that recurrences and progression affect nearly half of the diagnosed non-muscle invasive population, in part due to undetected lesions, misdiagnosis, delay of diagnosis and incomplete resection of tumors. The important role of quality surgery in NMIBC, including the use of enhanced cystoscopy, is widely recognized and an improvement of the TURBT procedure might have a larger impact on the outcome than any adjuvant therapy might have.3
References
- Castaneda, P. R., Theodorescu, D., Rosser, C. J. & Ahdoot, M. Identifying novel biomarkers associated with bladder cancer treatment outcomes. Front Oncol 13, 1114203, doi:10.3389/fonc.2023.1114203 (2023).
- Non muscle-invasive bladder cancer report, May 2025 (https://www.giiresearch.com/report/go1737296-non-muscle-invasive-bladder-cancer.html).
- Brausi, M. et al. Variability in the recurrence rate at first follow-up cystoscopy after TUR in stage Ta T1 transitional cell carcinoma of the bladder: a combined analysis of seven EORTC studies. Eur Urol 41, 523-531, doi:10.1016/s0302-2838(02)00068-4 (2002).