Endoscopic CryoSpray Technology Lets University of Rochester Medical Center Doctors Freeze Tumors

May. 18, 2009
Vivek Kaul, M.D., center, an interventional gastroenterologist, believes Cryospray Ablation Therapy is an effective treatment for people who can not undergo surgery for esophageal dysplasia.

Interventional gastroenterologists at the University of Rochester Medical Center are the first in upstate New York to treat early esophageal tumors and precancerous growths with a deep-freezing spray of liquid nitrogen.

Doctors are using Cryo-Spray Ablation Therapy, a new technology only available at 70 centers across the country, to treat a variety of conditions, including dysplastic Barrett’s esophagus and early gastrointestinal tumors and dysplasia (pre-cancerous tissue changes.) Often the location of these lesions makes them difficult to remove with traditional surgery.

Cryoablation has been used for decades to freeze-off warts but is now available to use endoscopically, which is a minimally invasive technique.

“This new technology opens up doors for people with tumors and pre-cancerous conditions in the gastrointestinal tract to receive a minimally invasive treatment on an outpatient basis,” said Vivek Kaul, M.D., F.A.C.G., associate professor of Medicine and director of clinical operations for Gastroenterology at Strong Memorial Hospital. He partners with surgeon Thomas Watson, M.D., chief of Thoracic Surgery, to bring the technology to the region’s patients and patients are treated in a multidisciplinary setting..

“The cryospray technique gives us another way to treat tumors and pre-cancerous lesions in the esophagus or stomach when surgery isn’t feasible,” Kaul said.  

Kaul is the first doctor in upstate New York trained to use the technology. He was recently invited to participate in a national panel discussion about the current technology and its applications and future research into the advancement of this technology.

Cryospray ablation is another option for doctors to treat Barrett’s esophagus with dysplasia or early cancer, a condition seen in people who have persistent heartburn or gastroesophageal reflux disease (GERD). More than 15 million Americans suffer from GERD, according to the American College of Gastroenterology. Over time, the constant splashing of stomach acid onto the esophagus can damage cells, which, if untreated, can become cancerous. 

Kaul, a gastroenterologist with additional fellowship training in advanced endoscopy, inserts a catheter through an endoscope and while visualizing the area, sprays liquid nitrogen to the area of targeted tissue. Over the next few days, the treated tissue sloughs off and is typically replaced by normal tissue, or the area of damaged tissue will shrink and will require subsequent treatments as indicated. Patients report that side effects are minimal, Kaul said.

Douglas Hough of East Bethany, Genesee County, was among the first patients to undergo this new procedure. The 62-year-old was diagnosed with Barrett’s esophagus with high-grade dysplasia more than a year ago and has been reluctant to have traditional surgery. The new minimally invasive procedure was appealing.

“It’s worked out very well for me,” said Hough, who works at Wyoming Correctional Facility. “I’ve had no problems and have been able to go to work the next day.”

The addition of this new technology and clinical treatment expands the expertise of the Medical Center’s growing gastrointestinal oncology program, which includes specialists in surgery, medicine, oncology, radiology and pathology.