Q: Stage 0 Esophageal Cancer - Treatment Options
HALO Radio Frequency Ablation is the treatment of choice for an increasing number of gastroenterologists which has proved to be 98.4% effective at completely healing High Grade Dysplasia. There are othe ablation therapies that aren't as effective: Argon Plasma Coagulation (APC), Phot Dynamic Therapy (PDT). Crotherapy is a newer ablation method which is also looking promising. All these methods are preferable to esophagectomy.
HALO is often preceded by Endoscopic Mucosal Resection to remove "lumps and bumps". HALO works best on a relatively smooth epithelium where it burns off a layer bewteen 500µm and 1,000µm. If the surface of your epithelium was corrugated to a depth greater than the initial burn, less will have been removed than required. Repeated treatments should gradually clear it.
It sounds as if your surgeon may have slightly underestimated the duration of burn required to penetrate the necessary depth. (This is still a relatively new technique and some practitioners may not be as practiced as we would like yet.)
Stage 0 Esophageal Cancer means the cells that have started to mutate are still within the mucosal layer which can be ablated. If it penetrates to the sub-mucosa (classified T1), there will be no option but esophagectomy.
This site: www.curebarretts.com has more information about HALO Radio Frequency Ablation therapy.
In Southampton UK, where I live, my charity purchased the HALO equipment for the local hospital and presented it last year where it is used, on average, to treat one patient per day. We are now receiving success stories as those who were amongst the first patients to benefit from it are found to be completely clear.
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Thank you for the thorough response.
My doctor first thought that cryoablation would be a better option, but went with the RFA because of the relatively large area involved. I am 51 years old, active and healthy, and really dreading the possibility of a full esophagectomy. My concern is that the ablation is not doing the job.
On a positive note, I think I am the perfect example of how early detection is important. This is a terrible form of cancer for most people because symptoms are usually apparent only when the disease has progressed very far. For me it was discovered well before major symptoms, when treatment options still exist.
Thank you again!