Non-invasive treatment for Barrett’s oesophagus now available at London Bridge Hospital14 April 2015
A non-invasive treatment for Barrett’s oesophagus is now available at London Bridge Hospital, which is changing the way dysplasia and cancer of the oesophagus (Adenocarcinoma) is treated. This new service is being led by Dr Jason Dunn, Consultant Gastroenterologist.
Barrett’s oesophagus is a pre-cancerous condition associated with Gastro-oesophageal reflux disease and central obesity. It is estimated that 13% of people who have chronic acid reflux also have Barrett’s oesophagus. Men develop Barrett’s oesophagus twice as often as women, and Caucasian men are affected more often than men of other races. It carries a low but unpredictable risk of progression to oesophageal cancer, which has been the subject of a recent Department of Health National Heartburn Awareness campaign.
Unfortunately, the prognosis of oesophageal cancer remains poor, despite centres of surgical and oncology excellence, as the cancer is often found at a late stage. As the majority arise in Barrett’s oesophagus, early endoscopic detection is important as it is associated with better outcomes. Dysplasia, a change in the Barrett’s cells that can lead to cancer, is at present the best marker of cancer risk, which is considered high enough to warrant treatment to remove the affected Barrett’s lining. This was until recently recommended by major surgery.
New NICE approved minimally invasive endoscopic techniques allow the removal of the abnormal Barrett’s lining without the need for surgery. This can either be achieved by Radiofrequency Ablation (RFA) alone or in combination with endoscopic mucosal resection (EMR).
The RFA technique uses an electrode mounted either on a balloon or endoscope, and enables the endoscopist to destroy the lining of the oesophagus by tissue vaporization. Once the abnormal Barrett’s lining is removed, the mucosa that regrows is usually normal squamous lining. A number of studies have demonstrated that RFA safely results in a high rate of complete eradication of Barrett's oesophagus, and hence reduced risk of cancer.
The EMR technique uses a snare device to remove areas within the Barrett's oesophagus lining which are raised or depressed, and thus suspicious for cancer. The benefit of EMR is that large biopsy specimens can be removed to render the lining flat. These are then reviewed by a team of expert GI pathologists and management based on the stage of disease.
The benefits of the new endotherapy service includes availability of advanced endoscopic therapy delivered as a day case procedure under sedation, with appropriate support services on site.
For more information, please contact Dr Jason Dunn on the contact details on his web profile here or firstname.lastname@example.org. If you have any further questions about the Endoscopy Department, please call the team on +44(0) 207 234 2447 or visit our detailed Endoscopy page here
For more information on the National Awareness campaign please visit -