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Photodynamic therapy (PDT) pairs a photosensitizing medicine with light to damage cancer cells in a targeted area. Improvements under study aim to make the medicine more selective, reach deeper tumors, and deliver light more precisely—but investigational approaches are not proven improvements in patient outcomes.
How photodynamic therapy works
A photosensitizer is given by mouth, applied to the skin, or administered intravenously, depending on the tumor site. Typically, light is applied 24 to 72 hours later, after more of the drug has left normal cells while remaining in cancer or precancer cells. When light of a suitable wavelength activates the medicine, it produces reactive oxygen that damages cancer cells. PDT may also damage blood vessels supplying a tumor and activate an immune response. The National Cancer Institute (NCI) explains the treatment and its U.S. uses; its overview was reviewed May 15, 2025.
Light delivery depends on where the target is. A clinician can direct light onto a skin lesion or, for tumors in the throat, airways, and lungs, guide it through an endoscope using a fiber-optic cable. Extracorporeal photopheresis is a related light-based procedure used for abnormal white blood cells in cutaneous T-cell lymphoma.
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In the United States, the NCI lists FDA-approved PDT uses for actinic keratosis, advanced cutaneous T-cell lymphoma, Barrett esophagus, basal cell skin cancer, esophageal cancer, non-small cell lung cancer, and stage 0 squamous cell skin cancer. PDT may also be used to relieve symptoms when some esophageal cancers block the throat or non-small cell lung cancers block the airways. Approval and availability can differ by country.
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PDT is a local treatment, not a whole-body therapy. The NCI says treatment light cannot pass through more than about 1 centimeter of tissue, which generally makes PDT more suitable for tumors on or just beneath the skin or on the lining of internal organs and cavities. Large or deep tumors are less suitable, and normal cells in the illuminated area can also be harmed.
What researchers are trying to improve
The NCI identifies several research goals: more powerful photosensitizers, more precise tumor targeting, light that penetrates farther into tissue, fewer side effects, better equipment, and improved light delivery. These goals address different constraints; a more potent medicine alone, for example, would not solve the limited depth of light penetration.
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More selective medicines and immune targeting
Researchers are studying photoimmunotherapy, which combines a photosensitizer with an immune protein to direct treatment toward cancer cells. The NCI describes studies in people with head and neck cancers. This is a developing approach, not a general replacement for established PDT uses.
Fluorescence-guided assessment followed by surgery and PDT
An active phase I/II colorectal cancer trial listing accessed October 7, 2026, describes fluorescence-guided tumor assessment followed by intraoperative PDT after surgery. Its objectives include evaluating safety and potential efficacy; those are questions the study is designed to answer, not demonstrated benefits. The listing names Roswell Park Comprehensive Cancer Center as lead organization and Anthony S. Dakwar as principal investigator. See the trial listing for its current status and details.
Fiber-delivered PDT for localized prostate cancer
A separate active phase I/II trial listing accessed October 7, 2026, studies verteporfin with the SpectraCure P18 system for localized prostate cancer. Optical fibers are inserted into the prostate to deliver light. The stated goals include collecting safety data, establishing dose parameters, and evaluating efficacy; the approach remains investigational in this listing. Check the listing for current status and details.
These trials illustrate different ways of approaching targeting and light delivery. They do not establish that either approach works better than the other or than standard treatment. Trial status and recruitment can change, so a listing marked active on October 7, 2026, may no longer be active.
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Benefits, side effects, and precautions
Because photosensitizers tend to accumulate in abnormal cells and light can be focused on a target, PDT can limit damage to healthy cells. The NCI also lists no scarring among PDT’s benefits, but local effects can include burns, swelling, pain, or scarring in the treatment area; effects depend in part on the site treated.
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Photosensitivity precautions vary by medicine. With porfimer sodium, skin and eyes may remain sensitive to light for about six weeks. The NCI advises avoiding direct sunlight and bright indoor light during that period. Do not apply this duration to every photosensitizer: follow the specific light-protection instructions from the treating team.
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What to ask about a proposed PDT treatment
If PDT is being considered, these questions can help clarify how well the treatment fits the situation:
Quick Recap
- Is this use established for the cancer type and location, or is it part of a clinical trial?
- How will light reach the target, and is the tumor shallow or accessible enough for that method?
- Which photosensitizer and administration route are planned, and what light precautions apply to that specific medicine?
- Is the goal to treat the cancer, reduce symptoms, or study safety and dose parameters?
- What local effects are likely at the treatment site, and what alternatives are appropriate?
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