The American Cancer Society estimates approximately 17,650 new cases each year and the associated prognosis is often poor. Over the course of the initial five years after diagnosis, patients have less than 50% survival rate, and this number can go as low as 5% for advanced cases where the disease has spread to distant parts of the body.
Now, researchers are hoping to improve early detection with a fairly basic approach, one that involves a tiny capsule, a 1.5 inch (2cm) sponge and string.
Stephen Meltzer, professor of medicine and oncology at the Johns Hopkins University School of Medicine, together with a team of researchers, clinicians, and biomedical engineers have developed a new test – the “EsophaCap” – that uses specific genetic biomarkers to detect dangerous changes in the cells that line the inside of the esophagus.
The procedure is pretty straightforward: the patient swallows a small capsule that has a long string attached to it. After the capsule makes its way down the esophagus and into the stomach – a process that takes only a minute or so – the gelatin coating on the capsule begins to dissolve. As the polyurethane sponge is slowly retrieved, it makes contact with the entire length of the patient’s esophagus, collecting genetic material.
“It’s actually possible to miss early cancerous cells using endoscopy with biopsy and most patients with Barrett’s don’t ever undergo endoscopy”, explained Dr. Meltzer. “Right now, we’re confident that we have the tools to identify this type of cancer. But we previously lacked a way to collect enough genetic material to confidently determine a patient’s diagnosis. We believe that EsophaCap now provides a solution to this serious problem”.
Testing usually focuses on the gene combination of p16, NELL1, AKAP12 and TAC1 which had provided a sensitivity of nearly 92% and has offered reliable diagnoses. Outside of endoscopy and biopsy, which are not ideal options, often inexact and expensive, there is no specific screening method for this disease.
“Early detection is the whole ballgame when it comes to esophageal cancer”, added Meltzer. “Patients have a much better chance to treat it – or even prevent it – if they know their risk. We believe this little sponge can bring easy and inexpensive screening to people around the world”.
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