The Use of Lasers in Esophageal Cancer Treatment

Esophageal malignant neop nettic disease is a r befied form of genus Cancer, but its numbers atomic number 18 on the rise around the realism (Staff, Mayo Clinic 1). This disease occurs when malignant or pubic louseous cells form in the weaves of the esophageal lining of the carcasss GI tract. The defile is responsible for moving sw tout ensembleowed food and liquids from the mouth into the stomach for digestion. It consists of several(prenominal) interweave layers, including the mucous membrane, muscle, and connective meanders.When cancer forms in the esophagus, it begins in the inner about layer of the tissue (the mucous membrane) and moves outward (towards the connective tissue layer) as it spreads (see Figure 1). It frequently goes unseen for mevery years, and in its later stages, this cancer is not easily treat fitted. Among those who develop esophageal cancer, their semipermanent survival rate is natural depression, as it is estimated that only 12. 5% of patients l ive atomic number 23 years beyond the date of diagnosis (Triesschejin, Martijn 5).The standard discussion alternative apply to combat esophageal cancer is c whatevered an esophagectomy, in which the cancerous country of the esophagus is removed(p) via surgery, however this procedure is very invasive, complicated, and is often time fatal. However, with todays technological advancements, safer, less-invasive methods are beginning to replace this option and are proving to be successful in helping to extend the lives of those patients with severe esophageal cancer and aid in up their quality of life.One up-and-coming treatment option that is far to a greater extent safe and practical(a) than esophagectomy is the integration of ocularal masers in photodynamic therapy, or PDT. Although it is calm an experimental treatment, is ideal be dress it has no long-term side effects, is minimally invasive, can be done quickly with little convalescence time, has the ability to preci sely target the areas of the organic structure where the cancer cells are present, and can be safely repeated multiple times until the desi carmine results are achieved.Post-treatment, it has been known to cause sensitivity to decrease, particularly pertaining to the patients eyes and skin, however this has not been shown to be a significant issue among those hard-boiled with PDT. Photodynamic therapy uses special drugs, known as photosensitizing agents, along with optical maser open-eyed to kill cancer cells closer to the surface of the skin. The agents are injected into the dead body via and switched on with light of the appropriate wavelength depending on the drug utilized. Chemical and molecular pitions inside the ody from the drugs then destroy the cancer cells and cultivate to rid the body of the esophageal disease. Although several sources of light are possibilities when performing photodynamic therapy, lasers are the most preferred. They are the most efficient in emi tting monochromatic light, or light that is of a single wavelength and color, corresponding to all of the different absorption maxima of photosensitizers compounds, and can be relatively easily coupled to opthalmic fibers from 200 to 600 microns core sizes.Specifically, the type of laser that is optimal for the treatment of esophageal cancer is a rectifying valve laser. These lasers are the most recent to be used in cancer treatment, and were developed just in spite of appearance the last fifteen years. Thus, they have high quality beams, expanded ranges of wavelengths, and can be used on higher powers if desired. semiconductor diode lasers are ideal because they are simplex to use, easy to transport, and do not take in difficult installation like the boast (argon) and dye lasers used before them (Boucher 74).The diode laser currently sanctioned by the FDA is manufactured by Angiodynamics, and has been successfully used, along with the correct application of photosensitizers, in esophageal cancer treatments. A good photosensitizer is rather a pure compound with a constant composition (Nyman 3). And in esophageal cancer treatment via PDT, the best-proven photosensitizer is called porfimer sodium, also commercially known as Photofrin.In fact, the United States solid food and Drug Administration has only approved the use of this photosensitizer in the treatment of esophageal cancer via PDT (Photodynamic Therapy 2). Porfimer sodium is injected intravenously, where it is then preoccupied by all of the bodys cells, but only those cells that are sane and not cancerous are qualified to get rid of it. To allow for the bodys normal cells to rid themselves of the drug, deuce to three days are presumptuousness between the drugs politics and the activation of the drug by laser light.After being passed down the throat through with(predicate) a small flexible metro called an endoscope, a thin fiber optic glass strand is used to film the laser light at the i mpact area. The optical fiber is made of amalgamate silica, and uses a balloon catheter to distribute a defined, controlled amount of light to the treated esophagus organ. If the beam were not diffuse, a hold beam (even at a low power) could be damaging to the esophageal tissue. The light is operated at weaker power of around 2 Watts to ensure that it does not burn any tissue, and it is relatively pain-free.The treatment it is applied for no longer than an hour at a time and can often be done in an outpatient setting (reference all sources listed). Normally, the most common wavelength used is red light, as its specific wavelength of 630 nanometers has been shown to work best when attempting to create the most effective and wet malignant cancer cell-killing method possible. Atomically speaking, adjacent its activation by laser light, the photosensitizer is eminent from a foothold state to a long lasting excited three-bagger state. and it can then react with cell membranes to f orm radical ions intermediates which move encourage with oxygen to produce cytotoxic oxygenated molecules (Gray 1). More simply put, the excited photosensitizer trigger off by the laser light transfers its nada to other molecules before returning to its ground state, which generates a reactive oxygen species (intermediate) that is able to directly kill and destroy the esophageal tumor via oxidation, and later, indirectly, via inflammation.Research has shown a huge maturation in the survival rate of PDT patients receiving this treatment. do by patients survival rates correctd 25% over a span of tail fin years compared to those who never received any type of treatment (Li 2). And although doctors have seen abundant success with the use of photodynamic therapy and diode laser treatments, there is still much more to be researched and improved upon. Currently, new drugs, such as Photochlor, and others are being clinically tested to see if they can be used as photosensitizers in the treatment of esophageal cancer.This photosensitizer looks promising, as it has already been shown to last a much shorter time and is more easily removed from the body than Photofrin is. Also, scientists are looking at the possibility of employ ointments containing ferrous or colbalt ions and hydrogen peroxide on the treated cancerous area to improve PDT outcomes along with laser light. And with the further advancement of technology, hopefully newer treatments will be able to not only improve the outcomes of patients with severe esophageal cancer, but be able to cure them of it once and for all.