Clinical Trials for Barrett's Esophagus

[Aub]

I had an upper GI for heartburn in February.  Everything looked good except a lot of erosion in the esophagus with no Barrett's esophagus.  Then in Sept. I had Nissan for heartburn and hiatal hernia.  Yesterday I had a follow-up upper GI and they discovered the beginnings of Barretts.  I came across an internet site, www.Barrx.com which is conducting clinical trials to wipe away Barretts with a laser of something like that and create a fresh surface.  I noticed OHSU is participating.  Is this a valid study? Does it really show promise?  I seem skeptical because they told me at the hospital where I had the upper GI that nothing can get rid of it.  I am worried because Barrets appeared so quickly after my exam in February.

[Kevin Pho, MD]

Typically, Barrett's esophagus is managed by surgical therapy - in cases of high-grade dysplasia - or with intensive endoscopic surveillence.  

Photodynamic therapy - not quite a laser - is an investigational option.  Typically this is used for high-grade dysplasia.  Surgery would still be the first choice.  Photodynamic therapy can be considered if surgery is not an option.

These questions can be discussed with your GI physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[TJV]

You most probably had the Barretts before and it was missed.

As for Barrx , i think the jury is stil out, as it is on all of the ablation procedures.  You may want to visit this message board from Johns Hopkins. http://pathology.jhu.edu/beweb_chat/  

  A lot of people on the above message board have already had the Barrx procedure done , and there are a lot of discussions and information on the subject.

[Aub]

I think the Forum MD gave a short answer.  It looks like this Barrx system does show some promise.

[TJV]

  I agree..... i don't think he is too familiar with Barrx, as it is relatively new.  . The Barrx studies ( radio frequency ablation ) have shown promise certainly.  There have been no buried glands thus far as there has been with PDT( photo dynamic therapy,)  and less complications .  But only time will tell. It is in the early stages and long term follow up is needed.  

  Many people have had their Barretts removed who had low grade or no dysplasia . , particularly with Dr Overholt  in Tenn , Dr Smith at Emory... and another doctor  i can't think of,  who sometimes answers questions on that message board i posted above.   There are also 2 women on that board who had their low grade Barretts done with Barrx  at the Mayo recently.  Good luck and take care . :)

[wassupwassabi]

If it was a choice between an experimental laser-like procedure and having major surgery, I would almost certainly at least try the laser like procedure first.  I highly doubt many people can maintain a fair quality of life after having their esophagus removed!  Even if a procedure isn't mainstream yet doesn't mean it doesn't work.  My grandma was treated for high grade dysplasia with the ablation treatment... it caused her swallowing difficulty for a while but I doubt she could have tolerated the surgery!

[Aub]

What they want to do is continuous monitoring.  I think they told me to go back in 1 year than every 2 or 3 years.  

Now,  I have also had polyps removed via colonoscopy.  They were the non-cancerous kind all except for maybe one that could have had the potential to turn into cancer.

Also,  several of my mothers family have had cancer.
My mothers sister colon cancer, my mother had cancer but they say it spread to her colon.  How do they know it wasn't the other way around.  

Somehow, I feel there may be a link to colon cancer and esophagus cancer.  That is why I believe in early treatment.  I have always heard, removing part of the esophagus doesn't always work.  Even in monitoring, I am skeptical.  

I tried a search on Barrx for a doctor in Seattle who does their proceedure but found none.  They are going to start doing this in Oregon. It really looks like to me that this is a cure.

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