Turning up the heat

New procedure removes pre-cancerous tissue in esophagus

Bob Crow had lived with indigestion for 40 years.

"Even coffee could bring it on," says the retired schoolteacher.

In 2008, the 68-year-old discovered his frequent bouts of heartburn were causing him more than discomfort. While in hospital for cardiac surgery, he was diagnosed with Barrett's Esophagus, which can develop when years of acid, food or bile reflux causes the canal that connects the throat to the stomach to become inflamed. In some cases, including Crow's, abnormal, pre-cancerous tissue develops without the individual suspecting anything is wrong.

"I didn’t have any symptoms," Crow says.

He was treated by the Royal Alexandra Hospital's endoscopy ablation therapy program, which helps about 50 patients with pre-cancerous and low-level cancerous tissue in their esophagus every year.

In fact, Crow was among the first Albertans to benefit from a new procedure to remove the pre-cancerous tissue: radiofrequency ablation therapy.

An endoscope (a thin, flexible telescope) equipped with a catheter is passed through the mouth into the esophagus. A radiofrequency generator creates sufficient heat in the catheter to destroy abnormal tissue upon contact. The dead tissue is removed without damage to the normal, underlying tissue, and new tissue grows back.

Dr. Clarence Wong, a gastroenterologist and medical director of the endoscopic ablation program at the Royal Alexandra Hospital, says the procedure is often used in conjunction with two other common therapies: endoscopic mucosal resection, which uses a wire loop to cut off abnormal tissue, and photodynamic therapy, where a laser activates a light-sensitive drug that can destroy the pre-cancerous cells on which it's applied.

"When a patient is referred to our clinic for assessment, we may choose a treatment plan that includes all three different therapies," says Wong. "They're all valuable for different aspects of treatment."

However, radiofrequency ablation therapy offers the patient some key benefits over its more aggressive sister-treatment, photodynamic therapy. Radiofrequency patients recover quicker and experience less pain. As well, patients don't become light sensitive, which is the case with photodynamic therapy. This sensitivity leaves individuals susceptible to sunburn.