New Treatment Uses Liquid Nitrogen to Prevent Esophageal Cancer Caused by Acid Reflux Disease
MAYWOOD, Ill. - From administering medication to providing support and comfort, nurses play very vital roles in the care of patients.
However, of all the things nurses do, probably one of their most important roles is helping to bring new leading-edge technologies and therapies to their own hospitals, clinics and medical centers.
At Loyola University Hospital in Maywood, Ill., Lynn Heicher, RN, MS, CGRN, CLNC, nurse manager of the gastroenterology lab, leads a team of nurses that has done just that. It was largely through the team's efforts that Loyola acquired a revolutionary new therapy called cryospray ablation. The therapy is a minimally invasive way to treat Barrett's esophagus, a pre-cancerous condition largely caused by acid reflux disease. If untreated, the condition could lead to esophageal cancer, the fastest-growing cancer in the United States, according to the American Cancer Society.
"Cryospray ablation uses super-cold liquid nitrogen to permanently destroy the pre-cancerous tissue in the esophagus," Heicher said. "After treatment, the pre-cancerous tissue eventually sloughs off and is replaced with normal, healthy tissue."
In this new treatment, the medical team inserts a catheter through an endoscope and sprays liquid nitrogen that's cooled to minus 270 degrees Fahrenheit onto the pre-cancerous tissue in the esophagus. The tissue is frozen for a few seconds, allowed to thaw and then refrozen. In most cases, patients experience no pain or bleeding during treatment and face a much lower risk of perforation.
So far, all of the patients treated with cryospray have had great results, which Heicher chalks up to the intensive training and preparation done by her and her team. The team left nothing to chance. They underwent multiple training sessions that lasted from an hour to an hour-and-a-half long.
They also reviewed Barrett's esophagus and nitrogen application as well as practiced setting up the cryospray machine, troubleshooting problems and doing dry runs in which each nurse played a different role from patient to physician.
"By the time the launch date came, we (the nurses) were extremely comfortable," Nancy Forcier, RN, said. "There was no fear of the unknown. We knew how to solve any potential problems and how to properly operate the equipment."
Forcier's colleagues Maureen Mackey, BSN, RN; Cynthia Webb, BSN, RN; and Ludy Umamos, BSN, RN, all agreed.
"We were extremely well prepared," Umamos said. "We were able to get it up and running without a hitch from the very beginning. From the start, everything has operated very seamlessly and has been well coordinated."
It takes an average of two to three sessions for all of the abnormal tissue to be destroyed with the new treatment. Depending on the patient's condition, sessions, which are repeated every six to eight weeks, last from 30 to 45 minutes and are performed on an outpatient basis. Patients are sedated during a session and are usually on their way back home about an hour after entering the recovery room.
"All of our patients have had great results. We would prefer to have these people treated with cryospray rather than having them going through a complex procedure called an esophagectomy, which can alter their quality of life," Heicher said.
Unlike other therapies to treat Barrett's, such as a technology that uses short bursts of intense heat to burn away abnormal tissue, patients treated at Loyola with cryospray ablation said they felt no pain following their procedures.
"With the heat, I had burning; it hurt for 10 days afterwards. It was just uncomfortable," said Angeline Johnson of Woodridge, Ill., whose Barrett's was more than 99 percent eliminated after her initial cryospray treatment. "With the cryospray, I could have gone out that day. It didn't feel like I had anything done. I didn't feel any discomfort at all."