BWT treats non-muscle invasive bladder cancer (NMIBC).
BWT provides bladder wall thermo-chemotherapy with uniform hyperthermia all over the bladder by high flow of a heated Mitomycin-C solution.BWT is based on conductive-heat which is better controlled in the bladder than microwave. In BWT, heat administered precisely and uniformly all over the bladder without burns ("hot spots”) or ineffective low heating ("cold spots”).
Bladder chemotherapy instillation (usually mitomycin C –
MMC) combined with hyperthermia (temperature range 40ºC-45ºC)
called "bladder thermo-chemotherapy” and its efficacy is due to the synergy
between two independent phenomena:
- Hyperthermia enhances drug uptake by cells and, independently,
- Hyperthermia selectively damages cancer cells and not the healthy tissue.
Efficacy of thermo-chemotherapy is temperature dependent
Efficacy of bladder thermo-chemotherapy instillations in
NMIBC is temperature dependent as proved in a very large cohort of patients
treated with 42ºC targeted temperature with a microwave system.
This large group of patients was divided retrospectively to
Patients that their treatments performed above 42ºC
Patients that their treatments performed below 42ºC
Comparison of the resulted efficacy by the two ranges of
temperatures showed 44% increase in efficacy in the group treated above 42ºC
vs. the group treated below 42ºC.
A closer analysis of the treatment efficacy in these patients showed that
efficacy is improving with higher temperatures along the whole range of
Bladder Wall Thermo-chemotherapy (BWT)
BWT provides chemotherapy instillation at a
uniform and precise 44.5ºC over the entire bladder lumen. Yet, with
no burns what-so-ever.
To secure drug stability and achieve an exact and
uniform temperature, BWT uses a carefully heated (to an exact temperature)
mitomycin C (MMC) solution which circulates through the bladder at a high flow
and the whole bladder content is replaced 4-5 times per minute.
BWT is unique due to the fact that the heat content of the
circulating drug solution exceeds what is required to transfer to the thermally
conductive bladder wall. Plenty of heat at a constant non-ablative temperature
assures best efficacy with
no burn what-so-ever because the bladder lumen
temperature is less than 45ºC at any time.
These simple principles enable precise and uniform highest
hyperthermia over the entire bladder lumen regardless of the fact that
different patients have different blood perfusion and different tissue
properties. Moreover, this simple controlled mechanism compensates easily for
dynamic changes that occur over time (such as vasodilation) with no need for
manual or software adjustments.
This sophisticated simplicity is a key factor for BWT inherent best efficacy,
best economics and for being the best user-friendly thermo-chemotherapy.
BWT (Bladder cancer) for NMIBC performed in two protocols
- Prophylaxis protocol: a 50 minutes procedure with uniform 44°C on bladder wall, in which 40mg Mitomycin-C dissolved in 50ml distilled water.
6 weekly induction instillations followed by 6 monthly maintenance instillations.
- Ablation protocol: a 50 minutes procedure with uniform 44°C on bladder wall, in which 80mg Mitomycin-C dissolved in 50ml distilled water.
6 weekly induction instillations followed by 10 monthly maintenance instillations.
BWT inherent features
- The better controlled conductive heat leads to better drug stability.
- The high rate circulation in the bladder continuously brings "fresh" heated drug in contact with all bladder wall.
- Uniform and precise bladder wall temperature maintained all over the bladder while there are:
The uniform and precise temperature enables increase of the targeted temperature to 44°C without adverse events.
- No "hot spots" (burns in posterior bladder wall), and
- No "cold spots" (ineffective low heating near the bladder dome or trigone).
- The absence of burns leads to increased patient tolerability to the treatment.
- Non-traumatic insertion of the 16Fr flexible catheter which has no rigid parts.
Over 18,000 procedures sold & performed
By 7x extended recurrence free interval
Good tolerance and minimal adverse events
Installed base: Switzerland, Germany, Spain, Turkey, Italy, Czech republic, Croatia and Israel