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Paul Basuk, M.D.
Director of the Endoscopy Unit in the Division of Digestive
Diseases at The New York Hospital-Cornell Medical Center
pmbasuk@mail.med.cornell.edu
 Patients with advanced esophageal cancer now have an alternative to the standard, and
often-times painful, Nd: YAG laser therapy. It is called Photofrin, a unique light-activated drug for photodynamic therapy and
it's now being used by physicians at The New York Hospital-Cornell Medical Center, one of only three medical centers in the city with this technology.
Photofrin is the first light-activated drug approved in the U.S. for the less-painful treatment of patients with completely obstructing
esophageal cancer, or of patients with partially obstructing esophageal cancer who, in the opinion of their physician,
cannot be satisfactorily treated with Nd: YAG laser therapy.
Three options existed for treating esophageal cancer before this: (1) the YAG laser, (2) removing the patients'
esophagus, a highly traumatic event , or (3) stenting, which involves forcing an opening in the esophagus, however, the tumor would eventually
grow around the stent.
Esophageal cancer, which affects men at three times the rate at which it affects women,
can block the passage of liquids and solid nutrition, and, at times, may prevent the patient from swallowing saliva. Photodynamic therapy is a
desirable treatment because it is a minimally invasive and highly specific technique that is administered on an outpatient basis, or otherwise
requires only a short hospital stay.
Photodynamic therapy uses Photofrin and a specially-adapted laser. The laser is positioned at the site of a tumor by a physician and
specifically targets and destroys cancer cells. Because Photofrin is retained to a greater degree by cancer cells than by healthy cells,
most of the healthy tissue surrounding the tumor is not affected. First, the drug is administered to patients intravenously two days prior
to application of the laser. It is absorbed by the tissues in the esophagus, including the cancerous tissue, over a period of approximately
40 to 50 hours. After that time, a small video probe is inserted into the patient's esophagus, where it directs low energy, non-thermal
laser light at the cancerous tissue. The laser light activates Photofrin, causing it to destroy tumor cells.
© 1999 New York Presbyterian Hospital
Weill Medical College of Cornell University
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