Cancer Treatment

Photo Detection

This is not a treatment as such but a means of detecting abnormal or pre-cancerous cells long beforethey are visibleto the naked eye. Using  a Fluorescence Bronchoscopy (FB) machine a flexible bronchoscope is attached to a camera head which then displays the image on a monitor. The FB has two functions; it can project a white light or a blue light. The white light lets the surgeon see things as if in daylight whereas the blue light will show any “abnormal” e.g. pre- cancerous cells as bright red; healthy tissue will appear to be green.

PhotoDynamic Therapy

Also know as PDT, this treatment has many modalities. The principle of PDT is that malignant tissue is photosensitised either systemically (via an injection), or topically (using a cream). After a preset amount of time has elapsed, which is dependant on photosensitiser that has been used; the treatment area is then exposed to a specific wavelength of light (632nm). The interaction between the light (which on its’ own has no effect) and the photosensitiser causes a chemical reaction in the cancerous cells causing them to break down. Healthy tissues remain unaffected as they are able to excrete thephotosensitiserprior to treatment commencing.

The YLC currently offers  PDT as a treatment option in;

·      Bronchus

·      Oesophagus

·      Gynaecology(VIN & VAIN)

·      Urinary Tract

·      Dermatology

·      Colo-rectal / General surgery

Urology

Lithotripsy – this is the breaking of stones in the Urinary tract. A high powered laser is fired in short but rapid pulses at the stone causing it to ablate. Due to the wavelength of the laser and its fibre optic delivery, laser lithotripsy causes far less trauma to the patient than conventional lithotripsy. Damage to the surrounding tissue is very rare.

Endopyelotomy

This is the treatment of a condition where the ureter (the pathway between the Kidneys & Bladder becomes restricted making the passing of Urine difficult or impossible.

An adjustable power, Thermal Diode laser is used to delicately burn away the blocking tissue and free the Ureter.

Gynaecology

VIN III / VaIN

Vulval / Vaginal intra-epithelial neoplasia is a pre-cancerous condition which responds well to PDT. Depending on the affected area patients are photosensitised with either a topical cream (more common) or systemically.

Miscellaneous

The YLC has been able to use a D60 Thermal laser for ablation in some Gynaecological applications. The adjustable power and shallow penetration of this laser makes it ideal for such procedures.

Photo Detection

We have recently acquired a “Woods Lamp”, this works, in principle, in a similar way to the FB unit discussed earlier. The key difference being that the area for examination needs to be photosensitised prior to examination. Under this light abnormalities (invisible to the naked eye) will fluoresce thus making targeted treatment possible.

General Surgery

Haemorrhoidectomy

A first in the UK! Following the removal of Haemorrhoids the standard procedure is to either suture or diathermy the flesh to seal the wound. We are using a Thermal Laser to coagulate these wounds, this gives a superior healing effect, virtually no bleeding and enables the patient to go home the same day. Prior to this they would have a 2 – 4 day inpatient stay.

Tumour Ablation

This has applications on a wide range oftumoursranging from Gastric, topical skin tumours, Thoracic et cetera.

Anal Intra-epithelial Neoplasia

Commonly known as AIN, this is a pre-cancerous condition and is thought to be caused by anal warts (Human Papilloma Virus) infection. This is more common in those with anal warts, HIV carriers and those on immuno suppressants following transplant surgery. The YLC have treated patients with all of these pre-disposing factors.

We have successfully treated patients suffering AIN with Photodynamic Therapy.

Also know as PDT, this treatment has many modalities. The principle of PDT is that abnormal tissue is photosensitised either systemically (via an injection), or topically (using a cream). After a preset amount of time has elapsed, which is dependant on which photosensitiser has been used; the treatment area is then exposed to a specific wavelength of light (632nm). The interaction between the light (which on its’ own has no effect) causes a chemical reaction in the abnormal cells causing them to breakdown. Healthy tissues remain unaffected as they are able so excrete thephotosensitiserprior to treatment commencing.

Depending on the positioning of the tumour within the Anus we have a range of PDT treatment options;

  • If the area is on the outside of the anus it will be suitable for a topical sensitiser and will be treated with a PDT LED lamp. This enables larger areas to be treated in one go, thus reducing the time under general anaesthetic.
  • If the area is deeper into the anus the patient may require systemic (injected) photosensitasation. These patients will be treated with a PDT 630nm Laser. This delivers the light to the treatment area via a Fibre Optic. We have a wide range of these which can project the beam in varying directions depending on the treatment needs of the patient.

Having had either form of PDT treatment, we would expect the patient would be well enough to return home the same day without the need for an overnight stay.

 

Research is progressing in other areas.

NICE has provided guidelines on PDT (www.nice.org.uk)

See also Cancer Research UK for advice on cancer treatment (www.cancerresearchuk.org)