A trial of white light or blue light surgery for people with bladder cancer (PHOTO)
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This trial compared a white light with a blue light during surgery to find and treat bladder cancer. It was for people with recently diagnosed non muscle invasive bladder cancer.
This trial was open for people to join between 2014 and 2018. The team published the results in 2022.
More about this trial
Doctors usually treat non muscle invasive bladder cancer with surgery. During this operation the surgeon removes the tumours. This surgery is a transurethral resection of bladder tumour or TURBT. The surgeon looks inside the bladder using a telescope called a cystoscope.
They usually shine a white light through the cystoscope to see the cancer and remove it. However this cancer often comes back (recurs) after surgery. This is thought to happen because the surgeons aren’t always able to see where all the cancer is when using the white light. So some of the cancer might be left behind.
In this trial researchers tested an experimental approach using a blue light during surgery with a liquid that they put into the bladder. The cancer cells absorb the liquid and glow red under the blue light. This may help them to see the cancer more clearly and remove it.
The aim of the trial was to compare the blue light with the standard white light during surgery to remove the cancer. They wanted to find out which way is better at showing up areas of cancer in the bladder during surgery. And so hopefully reduce the chances of the cancer coming back.
Summary of results
The team found that the blue light was not any better at stopping the cancer coming back than the standard white light.
Trial design
This was a phase 3 trial. It was a randomised trial. A computer put the people into 1 of 2 groups. Neither they nor their doctor chose which group they were in.
A total of 538 people took part, however some patients were unable to go on and have surgery within the trial. During their surgery to remove their cancer the surgeon planned to use:
- the blue light for 265 people
- the white light for 268 people
A further 18 people who were planned for surgery in the blue light group but had surgery using the white light.
Results
The team looked at the number of people whose cancer had come back. After a 
follow up of 44 months they found that the cancer had come back in:
- 86 people who had the blue light
- 84 people who had the white light
When bladder cancer comes back a worse type of cancer that grows deeper in the bladder wall or spreads beyond the bladder can also happen. This study also looked at the number of people whose cancer got worse. There was no difference between the 2 groups. They also found there was no difference between the number of people who died in both groups due to bladder cancer.
When they looked at the side effects reported in both groups, they found no difference.
The team found that using the blue light cost more than using the white light.
Conclusion
The team concluded that using the blue light to remove non muscle invasive bladder cancer was not any better than the white light in reducing the chances of the cancer coming back. They also found that it cost more to use.
Even though this trial shows that the blue light wasn’t any better it has added to our knowledge and understanding of this equipment.
These findings can help save the NHS money because centres can stop using the more expensive system without affecting patient care.
More detailed information
There is more information about this research in the reference below.
Please note, the article we link to here is not in plain English. It has been written for health care professionals and researchers.
A Randomized Trial of PHOTOdynamic Surgery in Non–Muscle-Invasive Bladder Cancer
Rakesh Heer, Rebecca Lewis and others
NEJM Evidence, 2022. September 2. Pages 1-10.
Where this information comes from
We have based this summary on the information in the article above. This has been reviewed by independent specialists () and published in a medical journal. We have not analysed the data ourselves. As far as we are aware, the link we list above is active and the article is free and available to view.
Recruitment start:
Recruitment end:
How to join a clinical trial
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Chief Investigator
Professor Rakesh Heer
Supported by
Clinical Trials and Statistics Unit at the Institute of Cancer Research (ICR-CTSU)
Experimental Cancer Medicine Centre (ECMC)
NIHR Clinical Research Network: Cancer
National Institute for Health Research (NIHR)
Newcastle University
The Newcastle upon Tyne Hospitals NHS Foundation Trust
University of Aberdeen
If you have questions about the trial please contact our cancer information nurses
Freephone 0808 800 4040
