Division of Gastroenterology and Hepatology
Barrett's Esophagus
Treatment for Dysplasia or Esophageal Adenocarcinoma
If a person with Barrett's esophagus is found to have high-grade dysplasia
or cancer, the doctor will discuss treatment options. These options include:
- Surgery: This is usually recommended for those in good
health with high-grade dysplasia or early stage cancer. The type of surgery
may vary, but it usually involves removing most of the esophagus and pulling
the stomach up into the chest to attach it to what remains of the esophagus.
Many patients with Barrett's esophagus and high-grade dysplasia or cancer
are elderly or have medical conditions that make surgery unwise.
- Endoscopic ablation: In these techniques, the Barrett’s
lining is destroyed and healthy tissue is allowed to grow in its place. These
treatments are given during upper endoscopy, and no surgery is required.
Treatment options include photodynamic therapy (PDT), radiofrequency ablation,
and cryotherapy. In PDT, a light-sensitizing drug and laser are used to destroy
the abnormal tissue. Extensive data is available on the success and risks
of PDT. The drawbacks of PDT include pain after the procedure, risk of stricture
(esophageal scarring), and need to avoid direct sunlight for 4-6 weeks. In
cryotherapy, the tissue is destroyed by exposing the cells to extreme cold
using liquid nitrogen. Early results from this technique show similar success
rates to PDT for removal of the abnormal tissue with significantly less side
effects.
This page was last updated on: December 12, 2007.
For patient inquiries, call 1-800-492-5538 or If you prefer, you may call the division directly
at 410-328-5780.