The summer sun is scorching hot in Texas these days but Dr. Jayaprakash Sreenarasimhaiah is keeping things cool inside the University of Texas Southwestern Medical Center in Dallas, where he is actually using liquid nitrogen to freeze damaged esophageal cells to kill them before they transform into cancer. The specialized equipment needed for this life-saving procedure is available in only a few facilities nationwide but the therapeutic relief the procedure brings is sure to interest millions of Americans.

Years of irritation of the esophageal surface caused by the splashing up of stomach acid, or chronic heartburn, can lead to the diagnosis of Barrett’s esophagus. Over time, Barrett’s esophagus can progress to Barrett’s esophagus with dysplasia, which means the cells lining the esophagus are transforming and have a tendency to become cancerous.

Traditional treatment for Barrett’s esophagus with dysplasia includes endoscopic mucosal resection, or EMR, a procedure that takes many hours and comes with the risk of post-surgical bleeding and narrowing of the esophageal tube. When damage is especially extensive, the injured portions of the esophagus can be removed. Either situation requires invasive surgery and anesthesia, both of which can be very risky for patients who are elderly and those who are too sick from cardiovascular disease for surgery.

Sreenarasimhaiah’s procedure, however, is not invasive, meaning it requires no incisions. It also takes less than an hour and requires only sedation. And it can be performed repeatedly, until all signs of dysplasia are gone.

The procedure, called cryoablation therapy, is approved by the US Food and Drug Administration for the treatment of Barrett’s esophagus with dysplasia and works in much the same manner a dermatologist freezes off a wart.

A special, liquid-nitrogen-spraying catheter is inserted down a patient’s throat and the liquid nitrogen is sprayed onto the damaged lining of the esophagus. The liquid nitrogen freezes the cells lining the esophagus, causing them to die. The treated cells fall away from the esophagus and are replaced by new, healthy cells in six to eight weeks’ time.

Some patients experience a little pain similar to heartburn but the pain usually lasts no longer than a few days. No special diets are required after surgery and patients can eat immediately after getting the procedure. Since the esophagus was damaged by the reflux of stomach acid, though, anti-reflux medications must be taken to prevent further damage.

Source: UT Southwestern Medical Center