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Procedure for Patients at Risk for Esophageal Cancer Being Studied at Thomas Jefferson University Hospital
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Insertion of ablation balloon followed by inflation
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A new nonsurgical procedure for people who suffer from Barrett’s esophagus is being studied at Thomas Jefferson University
Hospital in Philadelphia.
Barrett’s esophagus, the result of prolonged gastroesophageal reflux disease (GERD), is a condition where the cells on the
lining of the food tube become altered. The lining cells may develop dysplasia (microscopic cell changes) that, in time, may
become cancerous.
Jefferson Hospital is one of 18 sites nationwide to be involved in the clinical study. Patients are eligible to participate
when dysplasia has been confirmed on their esophagus, says Anthony Infantolino, MD, lead investigator.
(The procedure is also being used, on occasion, for patients who have Barrett’s esophagus but no dysplasia. Patients in this
group are not eligible for the study.)
The procedure involves the ablation (removal) of the precancerous cells found on the upper layers that line the esophagus.
If these cells are not removed, a cancer known as adenocarcinoma may result. Adenocarcinoma, resulting from Barrett’s esophagus,
is among the fastest growing gastrointestinal cancers.
Simple, outpatient procedure
This simple procedure takes about 30 minutes. Dr. Infantolino, who is Clinical Assistant Professor of Medicine at Jefferson
Medical College of Thomas Jefferson University, performs it on an outpatient basis. “This procedure is for selected patients
who have confirmed dysplasia and who have not had surgery to treat their Barrett’s esophagus,” he says.
To perform the procedure, the patient is sedated. Dr. Infantolino inserts a catheter with a sizing balloon (a tubular, flexible
surgical instrument for sizing the esophagus) through the mouth and into the patient's esophagus. Next, he delivers a correctly
sized ablation balloon to the affected area. Once at the spot to be treated, he activates a rapid burst of radiofrequency
energy (less than one second) to ablate the cells.
“Most patients will have minimal side effects and be able to resume their regular activities within hours,” he says.
Ablation vs. acid blockers
According to Dr. Infantolino, who is also Co-director of the Photodynamic Therapy, Endoscopic Ultrasound and Capsule Endoscopy
Program in the Division of Gastroenterology and Hepatology of the Department of Medicine at Thomas Jefferson University Hospital,
patients who traditionally suffer from Barrett’s esophagus are treated with a class of acid blocker prescription drugs called
proton-pump inhibitors (PPIs).
“This study will also enable us to compare the long-term effectiveness of balloon ablation therapy compared to taking acid
blockers alone,” he says. “Some of the patients in the study will take the medication, and others will undergo the procedure.”
“The results of this study will aid in our treatment of patients,” Dr. Infantolino adds. “Currently, if the Barrett’s esophagus
is severe and/or if there is low-grade dysplasia, we recommend that a patient who is taking a PPI undergo an endoscopy procedure
(visual examination using a flexible fibreoptic instrument known as an endoscope) every one or two years to check on the progress
of the cells on the esophagus. This process is known as “watchful waiting.”
For information about treatment for gastrointestinal problems or to make an appointment with a Jefferson digestive disease
specialist, call 1-800-JEFF-NOW.
