For national health care services, using fluorescence cystoscopy to examine the bladder of bladder cancer patients is clearly cost-effective. This is shown in a new health economy study carried out in Germany which has recently been published in the professional journal European Urology(1). After only seven years, the costs of the procedure are reduced by 68% if fluorescent cystoscopy is used. The study followed 301 patients for 7.1 years. Patients that were examined using standard cystoscopy had a recurrence rate of 42%. Those who in addition were examined using fluorescence cystoscopy had only an 18% recurrence rate. Because more tumours were discovered and removed during the first procedure with the help of fluorescence cystoscopy, these patients required fewer follow-up procedures. The annual expense per patient was thus lower. A patient examined using standard cystoscopy costs EUR 246 per year while for patients examined using fluorescence cystoscopy the figure is EUR 78. Annual savings amounted to EUR 168 per patient (68%). More tumours discovered Two new studies published in the latest edition of the Journal of Urology confirm previous findings with respect to significantly better tumour discovery using fluorescence cystoscopy2, 3: * In 29% of the bladder cancer patients, tumours were found with fluorescence cystoscopy that had not been discovered using standard cystoscopy. * A third of the tumours that were only visible using fluorescence cystoscopy were aggressive and growing rapidly. * Fluorescence cystoscopy resulted in significantly more very aggressive cancerous growths (carcinoma in situ) being found. Of 113 tumours, only 68% were found using standard cystoscopy while with fluorescence cystoscopy, 92% of the tumours were found. * In three patients, fluorescence cystoscopy helped to find tumours that had begun to grow into the bladder wall, and which had previously not been discovered. * Very high risk of recurrence Cancer of the urinary bladder is the sixth most prevalent cancer in Norway, while also being one of the most unknown. The risk of recurrence is very high - it occurs in some 50-75% of the cases. All patients must be regularly monitored and in many cases new growths have to be removed several times a year for the rest of their lives. It is important to find new tumours early and remove them before the disease becomes serious. Fluorescence cystoscopy enables doctors to discover the usually invisible tumours in many patients; in other words, tumours the doctor does not usually discover using standard cystoscopy. "The new method helps doctors discover dangerous changes early on; cell changes that are difficult or impossible to see with the naked eye," says Kjetil Hestdal, President and CEO at Photocure. "We hope the method will be able to contribute to reducing the number of procedures for each patient by enabling the doctor to actually find all changes once they are in the bladder and operating. Many of the recurrences are probably tumours that were not possible to see during the first operation." The new method entails instilling a pharmaceutical, Hexvix, into the bladder an hour before the examination. The drug is absorbed by cancer cells, and makes them sensitive to the blue light used in fluorescence cystoscopy. When the doctors then examine the bladder by viewing inside it with the help of both white light, which has been the standard method, and blue light, the cancer cells glow red when they are hit by the blue light. Scientific articles: 1 Photodynamic Diagnostics and Noninvasive Bladder Cancer: Is It Cost-Effective in Long-Term Application? A Germany-Based Cost Analysis http://www.sciencedirect.com/science 2 A Phase III, Multicenter Comparison of Hexaminolevulinate Fluorescence Cystoscopy and White Light Cystoscopy for the Detection of Superficial Papillary Lesions in Patients with Bladder Cancer http://www.jurology.com/article/PIIS0022534707005435/abstract 3 A Comparison of Hexaminolevulinate Fluorescence Cystoscopy and White Light Cystoscopy for the Detection of Carcinoma In Situ in Patients With Bladder Cancer: A Phase III, Multicenter Study http://www.jurology.com/article/PIIS0022534707005368/abstract For further information, contact: President and CEO Kjetil Hestdal E-mail: [email protected] Mobile: +47 913 19 535 www.photocure.com +47 22062210 Facts about bladder cancer * Every week about 18 Norwegian men and 6 Norwegian women are diagnosed with cancer of the urinary bladder. Cancer of the urinary bladder was the sixth most common form of cancer in 2005, after prostate cancer, breast cancer, lung cancer and colon and rectal cancer. * There are two main varieties of the disease, one superficial and one invasive type. The superficial type is seldom life-threatening, unless it grows deeper into the mucous membrane and develops into an invasive tumour. Invasive tumours have poorer prognoses. Two-thirds (75-85%) of all newly diagnosed bladder cancers are superficial, while about a fourth are invasive. * Of all the types of cancer, bladder cancer is the form that has the most recurrences. It is the superficial type that most often is characterised by recurrences. * Recurrences should be diagnosed as early as possible. Most patients are therefore monitored regularly so that recurrences can be treated before the more serious cancer appears. Treatment and monitoring will usually be carried out for the rest of the patient's lifetime. * Patients with superficial bladder cancer undergo regular check-ups. After the surgery, the check-up takes place every fourth month and thereafter somewhat less frequently, given that there is no recurrence. * No other form of cancer has such a large proportion of long-term survivors, patients who must be monitored and treated afterwards. * During check-ups, the doctor uses a cystoscopy to view the bladder. The tumours that are discovered are then removed through the urethra. The patient is usually given lumbar anaesthesia. * In 2004, over 85,000 hospital contacts were registered due to a diagnosis of bladder cancer. 85% of the contacts took place in out-patient clinics. (Hospital contact = one hospital admission or one consultation at any clinic.) * Bladder cancer is thus one of the most expensive forms of cancer to treat. International estimates show that bladder cancer is twice as expensive to treat as for example prostate cancer. * Anxiety and suffering can be reduced and money saved if the number of recurrences can be reduced. Facts about Photocure Photocure ASA is a Norwegian pharmaceutical company listed on the Oslo Stock Exchange. The company develops and sells pharmaceuticals and medical devices for the photodynamic treatment and diagnosis of different types of cancer. Photocure has three products on the market: Metvix® cream combined with the Aktilite® lamp for the treatment of sun-damaged skin and certain types of skin cancer, and Hexvix® for the diagnosis of bladder cancer. In addition, the company has several follow-on products and technologies in the pipeline.