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University Hospital is first in region to offer treatment to precursor of esophageal cancer

SYRACUSE, N.Y. — University Hospital is the only hospital in the region to offer the most advanced, non-surgical treatment proven in clinical trials to cure Barrett's esophagus, a precursor to a type of esophageal cancer. Rates of esophageal cancer have been rising rapidly in the United States.

According to University Hospital gastroenterologist Ronald Szyjkowski, M.D., who brought the technique to the region, the standard of care for other precancerous conditions, such as polyps, is to remove the suspected lesion. Yet, he says, the current standard of care for Barrett's esophagus is to survey patients on a periodic basis and watch and wait.

"This new FDA-approved treatment allows us to simultaneously prevent cancer and reduce anxiety for patients who have to live with a premalignant condition," said Szyjkowski.

The treatment uses an endoscope-mounted ablation system, called the HALO System by BARRX Medical Inc. The system has two components: an ablative energy generator and an ablation catheter featuring a small electrode that can be mounted on the end of an endoscope. It was approved by the Food and Drug Administration in 2006 and became commercially available in the United States this January.

Using standard endoscopic skills, the physician directs the ablation catheter to the diseased area of the sedated patient's esophagus. The HALO energy generator is then activated to deliver a rapid (less than one second) burst of ablative energy, or controlled heat, that removes less than a one millimeter layer of the diseased esophagus. The removal of tissue is tightly controlled so as to avoid injury to the normal, healthy underlying tissues. To date, the system has been safely evaluated in more than 5,000 patients.

"The 20-minute procedure is well tolerated by patients," said Szyjkowski, who added that patients can return to normal activity following the procedure. "Following ablation with the HALO System, the diseased tissue in most patients is replaced by new healthy tissue within three to four weeks."

In clinical studies, after 30 months more than 90 percent of participants were Barrett's-free after one to two treatment sessions. After more than two and a half years of treatment, 98.4 percent of patients with Barrett's had no residual Barrett's esophagus tissue.

Barrett's esophagus is a precancerous condition affecting the lining of the esophagus, the muscular tube that carries food, liquids and saliva from the mouth to the stomach. It results from chronic exposure of the esophagus to the gastric contents of the stomach caused by gastroesophageal reflux disease, commonly known as GERD. With prolonged acid exposure, normal cells can undergo a genetic change and transform into taller columnar cells. These Barrett's cells are vulnerable to further changes that can lead to a type of cancer called esophageal adenocarcinoma, which is currently the most rapidly rising cancer in the United States, affecting about 3 million adults.

In addition to the HALO System treatment, University Hospital offers the Plicator procedure for individuals who are dependent on medications or who would otherwise need surgery to control symptoms of heartburn and gastroesophageal reflux disease (GERD). The procedure, performed on an outpatient basis at University Hospital, has been shown to reduce or completely eliminate symptoms and medication use associated with GERD.

University Hospital is the teaching hospital of SUNY Upstate Medical University.

For more information on the above treatments, call 315-464-5801.

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