Photodynamic therapy now available to treat esophageal cancer

Patients diagnosed with esophageal or non-small cell lung cancer now have a new treatment option available to them at Boston Medical Center. Known as photodynamic therapy, or PDT, this minimally invasive procedure can offer patients a better quality of life by opening a blocked esophagus or obstructed bronchial passage.

Esophageal, lung and bronchial cancers are among the most deadly. The American Cancer Society estimates that there are approximately 13,900 cases of esophageal cancer and 13,000 deaths per year. In addition, more than 170,000 new cases of lung and bronchus cancers will occur, with approximately 150,000 people dying from the disease each year. Given the high incidence of these diseases, PDT offers physicians another treatment option when conventional approaches are not feasible.

Requiring minimal sedation and minimal endoscopic maneuvering, PDT is a two-step process. In the first stage, a photosensitive drug is injected into the patient. Within 40 to 72 hours, the drug passes through the body’s tissues but remains in tumors, skin cells and organs of the reticuloendothelial system.

Once the drug has exited healthy tissues, the second stage of the treatment involves using a laser to illuminate selected areas within the body that contain tumors. The laser activates the retained drug, thereby initiating a series of reactions that cause tumor cell damage and death.

Unlike radiation, PDT can be administered more than once for continued disease management. This procedure offers physicians the option of providing palliative care for untreatable cases of completely or partially obstructing esophageal cancer. In addition, PDT provides potentially curative therapy for microinvasive endobronchial non-small cell lung cancer patients for whom surgery and radiotherapy are not feasible. Surgeons may also utilize PDT for the ablation of high-grade dysplasia in patients with Barrett’s esophagus who are not candidates for esophagectomy.

Given PDT’s potential to ease breathing and swallowing in patients for whom it is an appropriate treatment, Boston Medical Center is pleased to offer this option. Hiran Fernando, M.D., MBBS, FRCS, Director of Minimally Invasive Surgery at Boston Medical Center, and Associate Professor of Cardiothoracic Surgery at Boston University School of Medicine, is a leading practitioner of this procedure and will be spearheading its implementation at BMC.

To learn more about PDT, or to refer a patient for evaluation, call Dr. Fernando at (617) 638-5600 or contact him via email at hiran.fernando@bmc.org. (no longer here)