New treatment freezes damaged cells in esophagusVictor Santiago appeared amazingly relaxed as he waited for his doctor to put a tube down his throat and spray the inside of his esophagus with liquid nitrogen. It didn’t bother him that he is among the first patients in North Texas to undergo cryoablation to treat damaged cells in the esophagus and prevent them from turning cancerous.
By: By Jan Jarvis, McClatchy Newspapers
FORT WORTH, Texas — Victor Santiago appeared amazingly relaxed as he waited for his doctor to put a tube down his throat and spray the inside of his esophagus with liquid nitrogen.
It didn’t bother him that he is among the first patients in North Texas to undergo cryoablation to treat damaged cells in the esophagus and prevent them from turning cancerous.
“It’s something new, and hopefully it will work,” said Santiago, 68. “It’s better than my other option: having surgery to remove part of my esophagus.”
Cryoablation has been used for decades to freeze off warts and more recently to treat prostate cancer. But in 2006 the Food and Drug Administration cleared the device for another use: treating damaged cells in the esophagus.
At the University of Texas Southwestern Medical Center at Dallas, doctors are using cryoablation to treat Barrett’s esophageal dysplasia, a condition commonly seen in people who have persistent heartburn or gastroesophageal reflux disease (also known as GERD). More than 15 million Americans suffer from GERD, according to the American College of Gastroenterology. Over time, the constant splashing of stomach acid onto the esophagus can damage cells, which, if untreated, can become cancerous.
The goal of cryoablation is to freeze the damage in its tracks, said Dr. Jayaprakash Sreenarasimhaiah, assistant professor of internal medicine at UT Southwestern Medical Center.
Cryoablation, which takes about 40 minutes, is an outpatient procedure and requires sedation. From a patient’s perspective, it’s no different than an endoscopy, a procedure in which a long slender tube with a tiny camera attached is used to see inside the esophagus. With cryoablation, another tube filled with liquid nitrogen is also inserted in the esophagus.
Once the esophagus can be viewed on a television screen, the physician paints the damaged tissue with liquid nitrogen, then waits a few seconds while the frozen area thaws.
Patients are able to eat normally the same day. In studies, the most significant side effect was mild chest pain; about 60 percent of patients did not even use Tylenol, said Patrick Clary, national product specialist for CSA Medical, which makes the equipment.
“This treatment is tough on the disease,” he said. “But it’s very easy on the patient.”
Six to eight weeks after treatment, the tissue that was frozen falls off, and normal cells replace it.
The procedure is especially well-suited for older patients who may not be good candidates for more surgery.
Alternative treatments involve scraping away damaged tissue, but they have side effects such as bleeding and narrowing of the esophagus. The most aggressive approach is to remove the esophagus.
So far about 1,000 patients nationwide have undergone the procedure, which is covered by Medicare and private insurance, Clary said. At UT Southwestern, about 10 patients have undergone cryoablation.
For Santiago, who has had acid reflux for years, being treated before the damage progressed to cancer was a huge relief.
“I wanted to try it out before anything else happened,” he said. “Hopefully it works.”