Thursday, September 02, 2010

Minimally Invasive Treatment for Esophageal Cancer

Under the direction of Wade Douglas, MD, surgical oncologist with the Marshall University Joan C. Edwards School of Medicine, Cabell Huntington Hospital now uses photodynamic therapy for partially or totally obstructing esophageal cancer and Barrett's Esophagus. According to the National Institutes of Health, Barrett's Esophagus is a condition in which the esophagus, the muscular tube that carries food and saliva from the mouth to the stomach, changes so that some of its lining is replaced by a type of tissue similar to that normally found in the intestine.

While Barrett's Esophagus may cause no symptoms itself, some people with this condition develop a relatively rare but often deadly type of cancer of the esophagus called esophageal adenocarcinoma. Barrett's Esophagus is estimated to affect about 700,000 adults in the United States. It is associated with the very common condition gastroesophageal reflux disease or GERD.

"Most people who have reflux use medication to take away the heartburn symptoms, but that does not seem to reduce the incidence of Barrett's Esophagus," Douglas said. "Constant reflux, even in people who have suppressed acid production, leads to precancerous changes in the lining of the esophagus, which can lead to cancer of the esophagus."

Photodynamic therapy is a treatment that uses a medication that is a photosensitizing agent, which is absorbed by cells all over the body, but stays in cancer cells longer than it does in normal cells. About 24 to 72 hours after the injection, when most of the agent has left normal cells, the tumor or cancerous tissue is exposed to a specific wavelength of light, which produces a form of oxygen that destroys the cancer cells.

"A recent study in the Journal of Gastroenterology showed this type of therapy has been successful 75 percent of the time in treating esophageal cancer without surgically removing the esophagus," Douglas said.

"Patients who smoke and are overweight are most at risk," he said. "And the incidence of esophageal cancer appears to be increasing most in the white male population. These patients need to be screened, and those with Barrett's Esophagus need to be closely monitored."

Photodynamic therapy is usually performed on an outpatient basis. More information about photodynamic therapy is available by calling (304) 399-6502.