by Andrew Bain, MD
Chief of Endoscopy
Endoscopy plays a paramount role in the diagnosis, staging, treatment, and palliation of esophageal cancer.
Diagnosis
Upper endoscopy (EGD) with biopsy is the gold standard for diagnosing esophageal malignancy. Roswell Park’s Endoscopy Center brings together advanced GI endoscopists, specifically trained in performing cancer-related endoscopy, with expert GI pathologists to ensure that a correct diagnosis is made.
Staging
Treatment and prognosis for esophageal cancer is stage-dependent. Endoscopic ultrasound (EUS) is the most accurate modality for determining locoregional staging of esophageal cancer. Roswell Park performs more than 800 EUS procedures per year and is the only center offering this service in the Buffalo/Niagara region. Accurate locoregional staging determines appropriate treatment.
Treatment
Once considered a surgical disease, early esophageal cancer and Barrett’s esophagus with dysplasia are now able to be cured endoscopically. If EUS shows that a tumor is located in the superficial mucosal layer of the esophagus, the tumor can often be removed with endoscopic mucosal resection (EMR) for a cure. Premalignant conditions of the esophagus, such as Barrett’s esophagus, can now be eradicated with such endoscopic procedures as EMR, radiofrequency ablation, cryotherapy and photodynamic therapy. By performing these minimally invasive endoscopic procedures often, Roswell Park’s advanced endoscopists can obviate the need for more-invasive surgical procedures.
Palliation
Advanced esophageal cancer can progress to narrow the esophageal lumen, causing swallowing difficulties. Placing a stent in the esophagus can open up the lumen and allow patients to resume a more normal diet, greatly improving a patient’s quality of life. Roswell Park's GI endoscopists are specially trained in advanced endoluminal stenting.
Roswell Park’s new state-of-the-art Endoscopy Center will equip fellowship-trained endoscopic oncologists with the most up-to-date technology to fight esophageal cancer in a setting designed specifically for that purpose.