Barrett’s Esophagus is diagnosed by having the patient undergo an upper endoscopy, a non-surgical procedure performed under conscious sedation. Because Barrett’s Esophagus tissue appears as a different colour on examination, a biopsy of the tissue is sent for evaluation. If intestinal cells are present, a Barrett’s Esophagus diagnosis is confirmed.
“The use of the new ablation technology will benefit patients with Barrett’s Esophagus as well as save thousands of dollars, which can be reinvested in cancer care,” said Health Services Minister Kevin Falcon. “Innovation is helping ensure a sustainable health system in British Columbia.”
“Barrett’s Esophagus develops in patients with gastroesophageal reflux disease where the stomach acid and enzymes cause damage to the lining of the esophagus and it becomes more like intestinal tissue. In about five to ten percent of patients, dysplastic lesions may develop which could progress to carcinoma,” says Dr. Alan Weiss, gastroenterologist at the BC Cancer Agency, an agency of the Provincial Health Services Authority and a Clinical Professor, Faculty of Medicine, University of British Columbia. “Ablation therapy is performed in conjunction with an upper endoscopy where a radio frequency ablation catheter is used to heat the Barrett’s Esophagus tissue until it is no longer viable. Patients generally tolerate the procedure well and are provided with medications to promote healing of their esophagus.”
Ablation therapy is performed as an outpatient procedure and is better tolerated by patients who were previously treated using Photodynamic Therapy (PDT), usually during a four day hospitalization. The purchase of the technology was made possible by a generous private donation.
According to John Cooper, a patient with Barrett’s Esophagus, “when I was told that a biopsy showed the Barrett’s Esophagus cells were changing and could become cancerous, there was a high probability I would need to have my esophagus removed in the very near future. I was referred to Dr. Weiss and during my ablation treatment, the bad cells were removed. I’m really happy to say I no longer face the prospect of major surgery.”
Prior to the availability of ablation therapy, BC Cancer Agency patients with Barrett’s Esophagus were treated with PDT. Patients were usually admitted to hospital on Sunday and injected with a photosensitizer, on Tuesday the affected tissue would be exposed to a laser light and then held for observation until the Thursday. PDT would leave their eyes and skin photosensitive for six to eight weeks after treatment leaving some unable to work if their profession required them to be outdoors.
“I’d like to extend our gratitude to the private donor who made this purchase possible as well as to Dr. Weiss and his team for pioneering the use of this therapy which is clearly beneficial for our patients,” says Dr. David Levy, President of the BC Cancer Agency. “Patients can be discharged sooner — safely back to their home and family.”
By moving to the HALO ablation technology, the agency is not only offering patients a better treatment option, it will also see savings. The first ablation treatment for a patient saves more than $11,200 and any subsequent treatments save $12,700. Dr. Weiss expects to treat 25 patients next year with the ablation therapy representing a savings of $280,000 which can be reallocated to other priority areas of cancer treatment.
The BC Cancer Agency, an agency of the Provincial Health Services Authority, is committed to reducing the incidence of cancer, reducing the mortality from cancer, and improving the quality of life of those living with cancer. It provides a comprehensive cancer control program for the people of British Columbia by working with community partners to deliver a range of oncology services, including prevention, early detection, diagnosis and treatment, research, education, supportive care, rehabilitation and palliative care. The BC Cancer Foundation raises funds to support research and enhancements to patient care at the BC Cancer Agency. www.bccancer.bc.ca
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