The Vision Forward:
How Blue-Light Cystoscopy Will Transform Patient Care at LMH
As a urologist, Dr. Jason Archambault has a hectic schedule, full of the variety that comes with working in a busy community hospital.
But he admits Tuesdays are more predictable than any other day.
On Tuesdays, he performs an average of 30 white-light cystoscopies; day procedures that examine patients’ bladders through scopes that illuminate the region with a white light. On Wednesdays, LMH’s other urologist performs more than 30 procedures.
“About half of these cystoscopies are with patients who have bladder cancer, or we’re checking to see if it’s come back, or they’ve been referred to us after they’ve shown blood in the urine,” says Dr. Archambault, who is also the head of surgery at LMH.
Despite their efficient work on more than 200 cystoscopy patients a month, LMH’s urologists still find themselves grappling with the limits of white-light cystoscopy, the only method currently available at LMH to diagnose and treat.
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Often, tumours appear flat on the bladder, and they’re difficult to view with white light, says Dr. Archambault.
“I’ll look in the bladder with white light, and I can't see anything. But I keep finding cancer cells in the patient’s urine, so I know there's cancer somewhere.”
Faced with this uncertainty, urologists must send patients to another medical site within the Fraser Health region for blue-light cystoscopy, a more effective method to confirm cancer diagnoses.
Aside from the inconvenience to the patient, the time involved in sending a patient elsewhere is critical and concerning: diagnosing bladder cancer early, is crucial, because tumours can spread quickly to muscle, hastening the disease’s impact and requiring the removal of the entire bladder– “a stage that is life-changing,” he says.
A blue-light cystoscopy tower at Langley Memorial would allow our specialists to diagnose patients in their own community, begin treatment quickly to eradicate the tumours, leading to quicker recovery.
Advantages of Blue-Light Cystoscopy
An hour before a cystoscopy procedure, a catheter is inserted through the urethra into the bladder, and a special imaging solution is left in the bladder. The imaging solution is absorbed by the cancer cells. Under blue light, the cancer cells glow fluorescent pink which makes it easier to see the edges of a tumour and to fully remove it from the bladder.
Once their bladder cancer is in an advanced stage, a patient has a 50 per cent survival rate after five years which makes access to this state-of-the-art technology critical to improving outcomes in Langley patients.
“The benefit is better detection, and then a more complete re-section [cutting the tumour from the bladder], which will lead to less recurrence,” says Archambault.
“I’ve had many patients that have been to the OR five or six times to have bladder tumours removed. So if you can identify them or [cut the tumour out] completely, that will reduce recurrence rates.”
Prevention and Treatment
More men than women are diagnosed with bladder cancer, leading to a slightly higher mortality rate, despite the best efforts of care teams: the 10-year survival rates for bladder cancer are 69 percent in women and 65 per cent for men, according to the Canadian Cancer Society.
Dr. Archambault says that attention to lifestyle and self-care practices may be the best way that adults can arm themselves against bladder cancer.
He advises patients to keep active and fit, to avoid smoking or break the habit altogether, and avoid exposure to industrial chemicals.
Dr. Archambault is confident that the addition of blue-light cystoscopy will lead to dramatic improvements in diagnosis and care of patients at Langley Memorial.
“Bladder tumors can be aggressive, but they’re on the surface so you can treat them better, initially prevent them from growing, or actually halt or prevent the progression of the disease.”
To help bring Blue-Light Cystoscopy to Langley Memorial Hospital, please make a donation here.