Bladder cancer is the most frequently occurring tumour of the urinary system.  Although many early bladder cancers are readily treatable with transurethral resection of bladder tumour (TURBT) it remains one of the most costly cancers to manage on a per patient basis because of its high prevalence, high recurrence rate, need for adjuvant treatments and the requirement for long-term cystoscopic surveillance. The total cost of treatment and 5-year follow-up of patients with Non Muscle Invasive Bladder Cancer (NMIBC) diagnosed during 2001–02 in the United Kingdom was £64 million.  From a patient perspective, there often are considerable anxieties about recurrences, surgery and progression requiring additional therapies with potential mortality and long term morbidity (e.g. radical surgery).  More efficient management strategies to reduce NMIBC recurrence and hence decrease both the burden to patients and costs to the NHS are urgently needed.

PHOTO is a multicentre randomised controlled phase III trial funded by the NIHR HTA Programme.

The PHOTO trial seeks to determine the efficacy of using photo-dynamic diagnosis (PDD) guided by a fluorescent tumour marker under blue light, instead of conventional white light, for TURBT in intermediate and high risk non-muscle invasive bladder cancer, and whether its implementation is worthwhile for the NHS.

The primary clinical outcome is time to recurrence, for each of the two treatment strategies, with a principal point of interest at 3 years.

The PHOTO trial aims to recruit 533 participants with suspected new diagnosis of intermediate/high risk NMIBC from at least 30 UK hospital sites.  Participants will be followed up regularly for 3 years.

The PHOTO trial is led by Dr Rakesh Heer based at the University of Newcastle and managed by CHaRT in collaboration with the Institute of Cancer Research Clinical Trials Unit. 

For more information please see the PHOTO Study Website



Ongoing - Writing up/analysis phase


Tandogdu Z, Lewis R, Duncan A, et al. Photodynamic versus white light-guided treatment of non-muscle invasive bladder cancer: a study protocol for a randomised trial of clinical and cost effectiveness. BMJ Open 2019;9:e022268. doi:10.1136/bmjopen-2018-022268