Return to Research+Publications list Treating Esophageal Cancer in Orange County The Beckman Laser Institute recently hosted Kenneth Chang, M.D., the first Orange County physician to use photodynamic laser therapy to treat esophageal cancer. The FDA-approved treatment, available through collaboration between the Institute and UC Irvine's Chao Family Comprehensive Cancer Center, should help the 10,000 esophageal cancer patients diagnosed annually.		During photodynamic therapy, Dr. Chang monitors co/or images of the esophagus on a television-like screen.
The FDA-approved treatment, available through collaboration between the Institute and UC Irvine's Chao Family Comprehensive Cancer Center, should help the 10,000 esophageal cancer patients diagnosed annually. Photodynamic therapy (PDT) is a two-step process that uses a light-activated drug and a laser. The drug Photofrin in this case is injected and localizes, or concentrates, in cancerous tissue. When the laser light shines on the affected area, the drug triggers a chemical reaction that kills the cancer, leaving the surrounding healthy tissue relatively untouched. Esophageal PDT During esophageal PDT, Dr. Chang, head of gastrointestinal oncology at UCI, and colleague Phuong Nguyen, M.D., use a hand-held probe called an endoscope. The endoscope contains specially-designed fibers that carry laser light to the site of the cancer. A tiny camera implanted in the instrument relays color images of the esophagus onto a television-like screen images that Dr. Chang uses to position the laser. Dr. Chang, an expert in endoscopic techniques with seven years of gastrointestinal oncology experience, says that PDT provides excellent results. Several days after PDT, the opening of the esophagus can be enlarged dramatically and patients once again can swallow without an operation or an esophageal prosthesis, he explains. PDT also can help patients whose esophageal prostheses, or stents, have failed to stop cancer from invading their esophagus. Dr. Chang explains, "I recently treated a 78-year-old woman with a history of esophageal cancer whose tumor was not responding to chemotherapy." He notes that physicians at UCLA had implanted a metal mesh stent in the patient's esophagus twice, and that cancer grew through the stent both times. The tumor was obstructing her esophagus and limiting her ability to swallow, Dr. Chang says. Now, four weeks after PDT, she is swallowing solids and liquids, and her weight has stabilized. She is very happy about the treatment. Previous Treatment Methods In the past, esophageal cancer has been treated by esophagectomy, surgically removing portions of the esophagus, a painful procedure with a high mortality rate. In contrast, PDT is a scalpel-free outpatient procedure. The entire treatment takes less than two hours; general anesthesia is not required. Although PDT is less invasive than esophagectomy, possible side effects include chest pain and pain during swallowing, both of which subside after several days. Patients also are advised to stay indoors for 30 days due to heightened sensitivity to sunlight. Institute Director Michael Berns, Ph.D., says that he is pleased that the Institute now can offer esophageal cancer treatment. Developing and providing new laser-based applications like esophageal PDT is the Beckman Laser Institute's goal, Dr. Berns explains. Esophageal PDT is a promising new laser application that builds on the Institute's basic science and preclinical research which, thanks to National Cancer Institute funding, has taken place here over the past 15 years, he adds. For more information about PDT to treat esophageal cancer, please call (714)456-8440.

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