New treatment to prevent cancer

DATE The study appears in the New England Journal of Medicine. It is a way to prevent esophageal cancers that have grown in frequency 500 percent since 1970.

It looks like a standard gastroscope used to examine the esophagus and stomach, but the way doctors used it may have changed Donald Yannella's life for the better. Yannella had Barrett's Esophagus, which is irritation from chronic acid reflux. A standard gastroscopy found it had developed into something worse.

"I had low-grade and possibly high-grade dysplasia at the bottom of my esophagus, where it meets the stomach," he said.

Dysplasia means pre-cancerous, and it meant that the area of the irritated esophagus, the Barrett's area, contained a piece that might mutate to esophageal cancer.

But the new tools can burn the pre-cancerous areas away and dramatically reduce the cancer risk, says the new study.

"The idea is to eliminate the pre-malignant tissue so that it doesn't develop into cancer," said Dr. Charles Lightdale, of NY Presbyterian/Columbia Medical Center.

The present treatment for pre-cancer is surgery. Patients have a high death rate and have their stomachs pulled into their chest to replace the esophagus.

"You have to learn to eat again with this new arrangement," Dr. Lightdale said. "And some of the side effects go on for the rest of their lives."

But not with this new device. Passed into the esophagus next to the scope, a balloon expands a copper grid that heats up and burns away pre-cancerous areas. It was 86 percent effective in removing pre-cancers.

The procedure is done as an outpatient and has very few side effects, perhaps some chest pain that clears up quickly.

After his procedure, Yannella spent time traveling with his kids and grandkids.

"This is quality time that I don't think I would have had if my esophagus had been removed," he said. "I would have been leaving a quasi-invalid's existence."

Not only do the pre-cancerous areas burn away, but the underlying Barrett's irritation burns away as well. It is replaced by normal tissue. Dr. Lightdale is planning a study to see if the burning method can not only remove pre-cancers, but can remove the Barrett's inflammation and cure the problem.

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WEB PRODUCED BY: Bill King


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