Oxidative stress is increased in bladder cancer patients. During this time, an unbalanced state of reactive oxygen species (ROS) production and antioxidant capacity occurs, which then causes oxidative damage, cell damage, and eventually death. Oxidative stress mediates the development of several diseases, including urothelial cancer.
Bladder cancer is one of the ten most common types of cancer diagnosed in the world. Modern fluorescence diagnostics of bladder neoplasms, combining fluorescence cystoscopy with other methods, shows great potential both in basic biomedical research and in clinical practice.
The aim of this research was to explain what fluorescence diagnostics is to present the techniques of modern fluorescence diagnostics of bladder tumors combining fluorescence cystoscopy with other methods. So far, several mechanistic pathways have been proposed and it has been experimentally proven that oxidative stress causes epigenetic changes. General DNA hypomethylation, promoter hypermethylation and ROS-induced altered histone modification have been clearly demonstrated.
Fluorescence cystoscopy is based on the evaluation of the bladder mucosa under ultraviolet light after prior intravesical administration of a photosensitizer (PS). Basically, light of a certain wavelength activates the PS, which then leads to a series of photochemical reactions that ideally allow tumor cells to be visualized without damaging normal tissue. PS: 5-aminolevulinic acid (5-ALA) and hexylaminolevulinate (HAL) are commonly used in fluorescence cystoscopy.
Blue Light Cystoscopy (BLC) is safe, well tested and effective in the treatment of bladder cancer and is well supported by high level evidence. The currently studied method, available and possible to implement, and at the same time more effective, is the combination of BLC with other methods of bladder cancer diagnosis. There is space and a need for further development and research in this area to minimize obstacles and introduce modern, improved diagnostic methods. In this paper, we present the current research reports on the generation and operation of ROS in bladder cancer.