On the forefront of cancer detection is a small sponge tucked inside a digestible capsule that can be swallowed. After the gelatin capsule dissolves, it expands in the stomach. The Cytosponge, as it is called, can then be pulled back up by a string attached to it. During extraction, the slightly abrasive mesh sponge picks up cells in its path.
The clever sponge can spot problems in the esophagus, the food pipe or gullet, in its earliest stages when the chance of successful treatment and remission are highest. A benign, nonmalignant condition called Barrett (or Barrett’s) esophagus – BE -often arises before full-blown esophageal adenocarcinoma (cancer of the esophagus).
With BE, abnormal cells develop in the lining of the esophagus. Identifying and monitoring patients with BE can lead to removing abnormal cells before esophageal cancer can develop.
BE is caused by long-term, chronic acid reflux, more commonly known as heartburn. Another name for this unpleasant condition is GERD (gastroesophageal reflux disease). Repeated exposure to regurgitated stomach acids irritates and inflames the lining of the food pipe.
A research team led by Professor Rebecca Fitzgerald at the University of Cambridge in England have come up with an invention that could take the place of the standard ways of detecting BE. The Cytosponge is forecast to reduce the need for either an endoscopy (a nonsurgical procedure where a flexible tube with a light and camera can display the patient’s digestive tract) or biopsy (the surgical removal of tissues or cells for lab analysis).
Manufactured by Ireland-headquartered Medtronic GI Solutions, the Cytosponge is used only once to collect cells from the lining of the esophagus. The collected cells are then analyzed using immunohistochemical staining to detect the presence of Trefoil factor 3 (TFF3), a biomarker that flags BE.
Bear in mind that most people diagnosed with BE will never develop esophageal cancer. However, this disease ranks #6 for cancer deaths. Men are more prone to this affliction than women. Localities that promote tobacco and alcohol use with high rates of obesity and poor diets have more occurrences of this dangerous carcinoma.
Identifying BE early and keeping an eye on it is vital for best possible outcomes. According to the Canadian Agency for Drugs and Technologies in Health:
“The five-year survival rate for early-stage esophageal adenocarcinoma, where cancer is confined to the superficial layers of the lining of the esophagus, is about 95%.”
Swallowing a little encapsulated sponge on a string and pulling it back out for evaluation is much easier for most patients and costs a lot less than the traditional modes of detection. No sedation is necessary and the procedure is relatively comfortable for patients. A nurse may collect the esophageal cells instead of a doctor, further reducing patient cost and increasing accessibility.
Some foods, medicines, overweight, and stress can all lead to a chronic cough that won’t go away, chest pain and burning.
The Mayo Clinic identifies the following risk factors that can contribute to esophageal cancer:
• GERD
• BE
• Smoking
• Obesity
• Alcohol consumption
• Bile reflux
• Difficulty swallowing due to an esophageal sphincter that won’t relax (a condition called achalasia)
• Regular and habitual drinking of very hot liquids
• Not enough fruits and vegetables in the diet
• Radiation treatment to the chest or upper abdomen
It is important to know the symptoms of esophageal cancer so it can be identified as early as possible. Consult with your healthcare provider if you have any of these signs or symptoms:
• Trouble swallowing (called dysphagia)
• Unintentional weight loss
• Chest pain, burning sensation, or pressure
• Indigestion or heartburn that gets worse, not better
• Persistent cough or hoarseness of voice
Advancing esophageal cancer can block the gullet, making eating and drinking difficult or even impossible. Pain is common, and there may be bleeding, either gradual or sudden and severe.
Not surprisingly, the way to prevent getting cancer of the esophagus is to quit smoking, eat more fruits and veggies, shed the extra pounds, and drink alcohol in moderation: one drink daily for women and men older than 65; two drinks for younger men.
We can thank the Medical Research Council and Cancer Research UK for providing funding to scientists associated with the National Institute for Health Research (NIHR) Clinical Investigation Ward at the Cambridge Clinical Research Facility where clinical patient trials are being conducted.
CBS News reported in 2014:
“Doctors tested the Cytosponge on more than a thousand people. The trial results claim more than 94 percent of the patients who swallowed the sponge reported no serious side effects.”
Problems with the Cytosponge device detaching from the retrieval string during withdrawal from the patient’s esophagus resulted in a product recall by Medtronic. However, once the kinks are ironed out of this remarkable new cancer-detection tool, we can expect the U.S. Federal Drug Administration (FDA) to approve it for use in the United States.
Low cost, ease of use, and effectiveness for preventative medical diagnosis all make the Cytosponge an easy pill to swallow.
