By Sara Bondell - May 14, 2019
When Howard Curd was told he would need radiation treatment for his esophageal cancer, he feared the worst.
“A lot of other patients told me about painful sore throats, their inability to eat and some said they struggled to speak,” said Curd.
Fortunately, Curd was eligible for a procedure that could make radiation treatment easier and more precise. Using an endoscopic ultrasound endoscope, gastroenterologists at Moffitt Cancer Center placed markers inside Curd’s esophagus to mark his tumor and guide radiation oncologists administering his radiation.
“A lot of times, tumors that are in the areas of the gastrointestinal tract move a lot,” said gastroenterologist Dr. Jason Klapman. “Tumors can move even with breathing, so it’s helpful to have these markers to guide oncologists so they know exactly where to radiate.”
For the patient, the procedure feels like a traditional endoscopy. Gastroenterologists use real-time ultrasound guidance to place the markers in the right spot.
The markers are used mostly in esophageal cancer patients undergoing radiation therapy before surgery and pancreatic patients with locally advanced disease with a low chance of becoming eligible for surgery. They have also been used in patients with liver and rectal cancers.
“These markers offer two major benefits for radiation oncologists,” said radiation oncologist Dr. Sarah Hoffe. “First, they identify the exact location of the tumor during each phase of the patient’s breathing cycle. Second, since imaging is available on the radiation treatment unit itself, they allow the radiation oncologist to ensure that the delivery is exactly in the right place every day. These two advantages enable smaller margins of normal tissues within the treated areas, leading to less side effects.”
The markers can also drastically reduce the amount of time patients spend getting radiation treatments. In some cases, what would traditionally take five weeks of radiation can be administered in just five days.
Curd just completed his radiation treatment, and says he believes the markers made a big difference. “I had a little discomfort, but nothing like I thought I would have,” he said. “I feel tired and still shocked I am going through this, but overall I feel pretty good.”