Forum

× click the New Topic button to post

Fluorescent diagnosis... and surgery?

7 years 4 months ago #38580 by Patricia
Hi Gabriel,
Narrow Band Imaging is what the major cancer centers seem to use as it does not require a waiting period of one hour as does the Hexvix. The dye has to be administered and the patient must wait one hour before the cystoscopy or TURB to take place.
This from Drs at Memorial Sloan
http://www.ncbi.nlm.nih.gov/pubmed/20707789
pat

Please Log in or Create an account to join the conversation.

7 years 4 months ago - 7 years 4 months ago #38579 by gabriel21
Having been researching the use of fluorescent light/dyes I've come to the conclusion that they are much more effective than white light. And it is not just the companies behind it who say this - there are numerous university studies using different solutions that confirm the effectiveness of fluorescent diagnoses: http://www.esru.be/sites/default/files/02_DE_WITTE_-_Photodiagnosis_and_photodynamic_therapy.pdf

Why isn't its usage more widespread?

1. More expensive?
2. It takes longer - patient turnaround in surgery?
3. Ignorance?

I can't access some of the later medical papers but would love to see some of your opinions on this. Thank you!


article excerpt:

In April 2011 a new publication on Hexvix® in British Journal of Urology (BJUI) was published. This study confirm the results from a large prospective international study published in the Journal of Urology in November 2010. The results of the trial demonstrate that Hexvix identified lesions, including residual tumours, that were not detected with white light alone in 49% of the patients. It also demonstrated that the improved detection of lesions resulted in a significant reduction in tumour recurrence within 12 months. [8] [9]
On 12th May 2011 it was announced results from a clinical study included retrospective follow up from 526 patients in a prospective randomized Phase III trial in 28 centers in EU and North America. After a follow-up period up to 5.5 years, the number of patients who have experienced recurrence of their bladder cancer is lower, and the time it takes before the recurrence occurs is longer when they had Hexvix-guided fluorescence cystoscopy. [10]

8 http://urotoday.com/bladder-cancer-1038/fluorescence-guided-transurethral-resection-of-bladder-tumours-reduces-bladder-tumour-recurrence-due-to-less-residual-tumour-tissue-in-t-at1-patients-a-randomized-two-centre-study-abstract.html Fluorescence-guided transurethral resection of bladder tumours reduces bladder tumour recurrence due to less residual tumour tissue in Ta/T1 patients A randomized two-centre study
9 http://www.newsweb.no/newsweb/search.do?messageId=278275 British Journal of Urology publishes paper on Hexvix®
10 http://www.medicalnewstoday.com/releases/225061.php Hexvix(R)/Cysview™ Demonstrates Long Term Benefit: Results From 5.5 Year Follow Up Of Recurrence Of Bladder Cancer
[edit]

My father is a male, 65, nonsmoker. Hematuria 01/08 TURB: T1 G3 widespread bladder+prostatic urethra; 3-month BCG.
Clean until 02/11: small TURB with no biopsy; 06/11 tumour detected TURB 08/11: awaiting biopsy, prostatic adenoma removed. Biopsies show both were benign. (...)

Please Log in or Create an account to join the conversation.

10 years 10 months ago #13532 by Julie
Gabriel, your question is answered on the first page on the Hexvix site which says it is not licensed in the US. So white light is the standard practice in the US. I believe the fluorescent exam is being tested at some sites in the US in preparation for approval by the FDA but I am not certain.

I think many of us would agree that we would want the best light available especially anyone who has CIS which is very hard to detect by the current methodology.

Volunteer Coordinator
ABLSC

Please Log in or Create an account to join the conversation.

10 years 10 months ago #13524 by gabriel21
Dear all,

I was wondering whether you consider fluorescent surgery important or not in the US?

I understand you do not use Hexvix, but do you use any alternatives to this?
http://www.hexvix.com/

Is the traditional white light still standard practice? I've read fluorescent practice is normally more targeted, meaning a surgeon doesn't have to guess what to scratch.

In our case, the surgeon - who is supposed to be the best at the hospital - apologised for perforating the bladder by saying "I know I scratched a bit too much, I just wanted to make sure it was as superficial as it seemed"...

Research shows fluorescent surgery is more precise.

Any comments or experienced views?

Best wishes

Gabriel


My father is a male, 65, nonsmoker. Hematuria 01/08 TURB: T1 G3 widespread bladder+prostatic urethra; 3-month BCG.
Clean until 02/11: small TURB with no biopsy; 06/11 tumour detected TURB 08/11: awaiting biopsy, prostatic adenoma removed. Biopsies show both were benign. (...)

Please Log in or Create an account to join the conversation.

10 years 10 months ago #12837 by gabriel21
Dear Joris

Apparently Hexvix has been introduced in Spain during 2007. Fortunately the hospital we're going to has already incorporated it.

Thanks for your info

Gabriel

My father is a male, 65, nonsmoker. Hematuria 01/08 TURB: T1 G3 widespread bladder+prostatic urethra; 3-month BCG.
Clean until 02/11: small TURB with no biopsy; 06/11 tumour detected TURB 08/11: awaiting biopsy, prostatic adenoma removed. Biopsies show both were benign. (...)

Please Log in or Create an account to join the conversation.

10 years 11 months ago #12622 by susanw
Hi,
Hexvix is not used much in the US, as it is still in clinical trials, but it is well worth looking into. There is more info here: http://blcwebcafe.org/hexvix.asp

All the best,
>Joris

Please Log in or Create an account to join the conversation.

  • Not Allowed: to create new topic.
  • Not Allowed: to reply.
  • Not Allowed: to add attachements.
  • Not Allowed: to edit your message.
Moderators: Cynthiaeddieksara.anne

Users

Total Online: 0 Users and 380 Guests 

Statistics

Total Messages: 50877 Total Sections: 1 Today Open: 0 Today Total Answer: 0
Total Subjects: 6518 Total Categories: 11 Yesterday Open: 0 Yesterday Total Answer: 4
Total Users: 7783 Latest User: sarahwelson
Powered by Kunena Forum