Heat treatment effective against early precursor of oesophageal cancer
A treatment that uses heat to kill abnormal cells lining the food pipe reduces the risk of an early form of a condition called Barrett’s oesophagus from progressing to oesophageal cancer, research from the Netherlands has shown.
“This study is important and shows that more people with Barrett’s oesophagus could benefit from radiofrequency ablation than previously thought" - Dr Rebecca Fitzgerald, Cancer Research UK
Radiofrequency ablation (RFA) uses a flexible tube called an endoscope to apply heat to abnormal cells lining the oesophagus, killing them off before cancer develops.
It is commonly used to target cells that doctors define as highly abnormal – a condition known as Barrett’s oesophagus with high grade dysplasia – and with potential to develop into oesophageal cancer more quickly.
But the latest research, published in Journal of the American Medical Association, shows that RFA may also benefit people with earlier ‘low-grade’ stages of Barrett’s oesophagus that can progress more slowly.
Barrett’s oesophagus is where cells lining the oesophagus change from their normal flat shape to a more abnormal rectangular shape. These abnormalities are referred to as dysplasia and doctors’ grade dysplasia from low to high.
Barrett’s oesophagus increases a person’s risk of developing oesophageal cancer, with between one and five per cent of patients going on to develop the disease.
In the latest study, 136 people with Barrett’s oesophagus with low-grade dysplasia were placed in groups to receive either RFA or monitoring of the cells using a camera. The researchers then tracked the patients’ progression to high-grade dysplasia and oesophageal cancer.
1.5 per cent of patients who received radiofrequency ablation progressed to high-grade dysplasia or oesophageal cancer, compared with 26.5 per cent of those who did not have the treatment. And the absolute risk of progressing to cancer was reduced by just over seven per cent.
Dr Rebecca Fitzgerald, a Cancer Research UK oesophageal cancer expert, said: “This study is important and shows that more people with Barrett’s oesophagus could benefit from radiofrequency ablation than previously thought. Early detection and treatment are vital in beating oesophageal cancer, and finding new ways to prevent the disease from progressing have a huge part to play.
“But before the benefits of this treatment can be fully realised, we also need to ensure that the way we diagnose each stage of Barrett’s oesophagus is accurate and consistent, so that we are sure we’re treating the right people.”
The National Institute for Health and Care Excellence (NICE) is currently in consultation on a potential update to its guidance to include RFA for patients with Barrett’s oesophagus and low grade dysplasia.
Copyright Press Association 2014
- Phoa K.N, et al. (2014). Radiofrequency Ablation vs Endoscopic Surveillance for Patients With Barrett Esophagus and Low-Grade Dysplasia, JAMA, 311 (12) 1209. DOI: 10.1001/jama.2014.2511