A Life Saving Trial: An Alternative to Barrett's Oesophagus

When Herb Harris learned he was showing dangerous signs of developing cancer, his age counted against him. the usual treatment for his condition, Barrett’s oesophagus with intraepithelial cancer, was extensive surgery, but this just wasn’t an option for the elderly Sydney man.

“It wasn’t looking too flash for me at first,” says Herb, an 85-year-old grandfather of four from the north shore.

Fortunately, Herb’s doctor referred him to Professor Reg Lord, who went on to include him in a trial in which surgery was replaced with endoscopic radiofrequency ablation.

Prof Lord explains that with patients such as Herb, who was showing several focuses of cancer cells, the risk of developing invasive cancer is as high as 40 percent.

“Until recently the treatment to remove these cells has been oesophagectomy, but as an elderly patient, Herb was not fit from an anaesthetic point of view to under go such a major procedure,” says Prof Lord, Program Head at St Vincent’s Centre for Applied Medical Research.

Herb was one of the first patients in Australia to receive the therapy, which was delivered every six months for three years on an outpatient basis by endoscopy at St Vincent’s Clinic.
“The difference in invasiveness of endoscopic procedure compared to oesophagectomy is vast,” says Prof Lord.

“And in his case, and in the case of all the patients who were in the preliminary trial, the Barrett’s oesophagus was, as far we can tell, completely cured.”

Prof Lord has received National Health and Medical Research Council funding to focus on laboratory studies to investigate the long-term likelihood that the patients are definitely cured. The initial Australian trial was held at St Vincent’s and Prof Lord said there were plans of a larger trial with centres in several states.

“The advantage offered by endoscopic treatment in this scenario has provided a spectacular advance in clinical management. In fact, I would say that surgery is now the second line treatment for patients with this problem and its role is to salvage patients who suffer treatment failure with endoscopic treatment.”

As for Herb – who is happy to report he doesn’t need any follow up treatment for another two years – he couldn’t be more grateful to have been included in the trial.

“My position didn’t look too good. I’ve been a pretty keen golfer and I could see me playing my next 18 holes up in the sky, but it all seems to have turned out really well now.”