01:18pm Friday 17 January 2020

Allegheny General Hospital Introduces New Treatment for Esophageal Disease

In 2005, Herman Ross learned that he would lose a lung to cancer. After his lung surgery his stomach started to bother him and he received another shocking diagnosis. He also had Barrett’s esophagus, a pre-cancerous condition that must be closely watched and aggressively treated.

Since then, the retired school administrator from Mather, Greene County, has worked with physicians to pinpoint and remove the dangerous tissue from his esophagus, the pipe that takes food and liquid from the mouth to the stomach.

In the past six months, physicians at Allegheny General Hospital have used a new method of removing damaged esophageal tissue that has given Mr. Ross peace of mind. His two latest surgeries were done with HALO, a system that uses concentrated heat energy to burn away, or ablate, the affected tissue.

“It’s evolving to where we don’t do surgery to correct the condition anymore, we ablate the tissue,” said Abhjit Kulkarni MD, Medical Director of the GI Lab at Allegheny General Hospital. “It’s the wave of the future.”

Barrett’s esophagus is the number one cause of esophageal cancer, which is one of the fastest growing cancers, Dr. Kulkarni said. Barrett’s esophagus affects approximately 3.3 million adults over age 50 in the United States, according to a 2005 study published in the American Gastroenterological Association journal.

The condition is caused by Gastroesophageal Reflux Disease or GERD, a disorder in which stomach acid and enzymes back up into the esophagus and injure its lining. Over time, this damage (dysplasia) can transform esophageal tissue into intestinal tissue and lead to cancer. Because Barrrett’s esophagus is a disease without symptoms, regular upper endoscopies and biopsies are required to determine if the disease has progressed or if cancer is present.

When Mr. Ross was diagnosed, he had high-grade dysplasia, a severe form of Barrett’s that very often progresses to invasive cancer. Traditional treatment usually consisted of surgical removal of nearly the entire esophagus. His doctors at AGH decided instead to proceed with an outpatient endoscopic treatment with the HALO device. Following his HALO ablation, he is being monitored for low-grade dysplasia with endoscopies every six to 12 months.

Clinical studies have shown that ablation therapy frequently results in complete eradication of Barrett’s esophagus and reduces the risk of cancer progression, according to the May 2009 New England Journal of Medicine.

These early successes and the precision of the ablation technology appealed to Mr. Ross.

“The machine can measure distances and remove the tissue to within 1/100 of an inch, where even a very skilled surgeon can only go by what he can observe and visualize,” Mr. Ross said. “I also think the HALO is less intrusive – you heal faster and it’s not such a shock to your system as manual tissue removal.”

Mr. Ross was eating soft foods two days after his ablation procedure and said discomfort from the procedure tapered off within a week. Even with only his smallest lung, he feels strong enough to plow and shoveled his own driveway and is pursuing his passion of working on cars. He and his sons are turning a 1955 Jeep into a hotrod, complete with a new V8 engine.


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