The Use of Lasers in Esophageal Cancer Treatment

esophageal malignant neoplastic disease is a rargon form of malignant neoplastic disease, unless its numbers argon on the rise nigh the world (Staff, Mayo Clinic 1). This disease occurs when malignant or pubic lo practiseous cells form in the tissues of the esophageal ocean liner of the physical structures gastrointestinal tract. The esophagus is responsible for(p) for moving swallowed food and liquids from the mouth into the stomach for digestion. It consists of some(prenominal) tissue layers, including the mucose membrane, muscle, and connective tissues.When cancer forms in the esophagus, it begins in the inner virtually layer of the tissue (the mucous membrane) and moves outward (towards the connective tissue layer) as it spreads (see count on 1). It often goes undetected for many years, and in its by and by stages, this cancer is non advantageously treat suit fitting. Among those who develop esophageal cancer, their long-term survival rate is low, as it is estimated that be fonts 12. 5% of patients live atomic number 23 years beyond the date of diagnosis (Triesschejin, Martijn 5).The standard discourse extract used to combat esophageal cancer is called an esophagectomy, in which the cancerous argona of the esophagus is removed via surgery, however this procedure is very invasive, complicated, and is often times fatal. However, with at at a times technological advancements, untroubledr, less-invasive methods are beginning to flip-flop this option and are proving to be successful in helping to extend the lives of those patients with severe esophageal cancer and aid in improving their quality of life.One energetic treatment option that is far more than safe and practical than esophagectomy is the integration of optical masers in photodynamic therapy, or PDT. Although it is electrostatic an experimental treatment, is ideal because it has no long-term side effects, is minimally invasive, can be done apace with little recovery time, has t he ability to precisely butt the areas of the body where the cancer cells are present, and can be safely repeated multiple times until the desired results are achieved.Post-treatment, it has been known to cause sensitivity to blowzy, peculiarly pertaining to the patients eyes and skin, however this has non been shown to be a significant issue among those do by with PDT. Photodynamic therapy uses special drugs, known as photosensitizing agents, along with laser baseless to kill cancer cells closer to the step up of the skin. The agents are injected into the body via and switched on with light of the admit wavelength depending on the drug utilized. Chemical and molecular reactions inside the ody from the drugs wherefore destroy the cancer cells and work to release the body of the esophageal disease. Although several sources of light are possibilities when performing photodynamic therapy, lasers are the some preferred. They are the most strong in emitting monochromatic lig ht, or light that is of a single wavelength and color, corresponding to all of the antithetic absorption maxima of photosensitizers compounds, and can be relatively easily coupled to optical fibers from 200 to 600 microns core sizes.Specifically, the eccentric person of laser that is optimal for the treatment of esophageal cancer is a rectifying tube laser. These lasers are the most fresh to be used in cancer treatment, and were real just within the last fifteen years. Thus, they live with higher quality beams, expanded ranges of wavelengths, and can be used on higher powers if desired. Diode lasers are ideal because they are simple to use, easy to transport, and do not require difficult installation exchangeable the gas (argon) and dye lasers used before them (Boucher 74).The diode laser currently approved by the FDA is manufacture by Angiodynamics, and has been successfully used, along with the correct lotion of photosensitizers, in esophageal cancer treatments. A effectu al photosensitizer is preferably 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 Food and Drug Administration has however 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 absorbed by all of the bodys cells, but alone those cells that are normal and not cancerous are able to get rid of it. To allow for the bodys normal cells to rid themselves of the drug, two to 3 days are given between the drugs administration and the activation of the drug by laser light.After being passed down the throat by means of a small flexible tube called an endoscope, a thin fiber optic glass concatenation is used to direct the laser light at the affected area. The optical fiber is made of fused silica, and u ses a balloon catheter to distribute a defined, controlled gist of light to the treated esophagus organ. If the beam were not diffuse, a direct 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 take care 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 ad hoc wavelength of 630 nanometers has been shown to work best when attempting to create the most effective and potent malignant cancer cell-killing method possible. Atomically speaking, next its activation by laser light, the photosensitizer is elevated from a ground state to a long constant excited triplet state. and it can then react with cell membranes to form radical ions intermediates which interact just with oxygen to produ ce cytotoxic oxygenated molecules (Gray 1). more simply put, the excited photosensitizer activated by the laser light transfers its energy to other molecules before reversive to its ground state, which generates a reactive oxygen species (intermediate) that is able to directly kill and destroy the esophageal neoplasm via oxidation, and later, indirectly, via inflammation.Research has shown a huge increase in the survival rate of PDT patients receiving this treatment. Treated patients survival rates meliorate 25% over a span of five years compared to those who never received any emblem of treatment (Li 2). And although doctors have seen great success with the use of photodynamic therapy and diode laser treatments, there is still oft more to be researched and improved upon. Currently, new drugs, such(prenominal) as Photochlor, and others are being clinically time-tested to see if they can be used as photosensitizers in the treatment of esophageal cancer.This photosensitizer look s 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 for at the possibility of using 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.