FS Regional Center of Excellence Offers Newest Minimally Invasive Treatments for Barrett’s Esophagus

Jimmy Millsaps of Maryville had struggled with gastroesophageal reflux disease (GERD) for years. GERD occurs when acid from the stomach backs up into the esophagus, causing symptoms of heartburn, regurgitation and chest discomfort.

“I couldn’t eat anything spicy, pizza or anything,” Millsaps said. “I could smell food and have heartburn!”

In 2012, Millsaps’ wife suggested he consult his physician. He was sent for an “upper scope” or EGD (esophagogastroduodenoscopy).

The test revealed a serious condition called Barrett’s esophagus, in which the cells lining the esophagus change. In Millsaps’ case, there were also some precancerous nodules in his esophagus.  People with Barrett’s esophagus are 30 times more likely to develop esophageal cancer than the average person.

Fortunately for Millsaps, the latest technologies to treat Barrett’s esophagus are available in Knoxville. The Center of Excellence for Barrett’s Esophagus at Fort Sanders Regional Medical Center has played a prominent role in developing minimally invasive treatments for this potentially life-threatening disease.

 “We were instrumental in developing one of the laser procedures for Barrett’s esophagus called photodynamic therapy that revolutionized the management of the disease,” said Masoud Panjehpour, Ph.D., director of the center.

“Before PDT, patients were sent to surgeons and the esophagus was taken out, which had a significant mortality rate. Although we no longer use PDT, we were also involved in clinical trials of even better treatments we use today,” said Panjehpour.

Currently there are four minimally invasive procedures conducted at the center. They each use an endoscope, a tiny camera inserted along with instruments into the esophagus:

• Radiofrequency ablation (RFA) uses electrical waves to produce heat to remove tissue.
• Argon Plasma Coagulation (APC) is a thermal technique for treating small areas of Barrett’s esophagus.
• Endoscopic mucosal resection (EMR) is a technique where the physician lifts a lesion, forming a tiny mushroom shape, which is then removed.
• Cryotherapy uses extreme cold to remove tissue.

Millsaps has received three of these treatments since 2012, each performed by John Haydek, MD, the center’s medical director.

“Jimmy is quite a lucky gentlemen to have had his Barrett’s esophagus diagnosed at the time he did. His life has certainly been altered by his diagnosis and treatment, since esophageal cancer can be deadly if not caught early.  His prognosis is excellent. He’s an extremely lucky guy,” said Dr. Haydek.

“I’ve never been treated better in my life than I have at Fort Sanders Regional,” said Millsaps. “That place is friendly, family-oriented, and efficient. You feel comfortable, they tell you what they’re going to do. Afterward, Dr. Haydek came out and showed me pictures of what he took out and what he fixed.

“That night or the next day he’ll call you and check on you personally, and tell you the results of the biopsy. And the next night one of the RNs will call and check on you,” Millsaps said. “They always ask me what I want after a treatment, and I say, ‘a good cup of coffee, because I haven’t had one today!’ So in the recovery area, the first thing they get me is a cup of coffee.”

Dr. Haydek noted that not all heartburn leads to cancer, but it’s important not to pop antacids and ignore the symptoms.

 “Heartburn sufferers should be evaluated by their medical provider for the possibility of Barrett’s esophagus. If you’re at high risk for Barrett’s esophagus, your medical provider may order an EGD,” he said.

“If you need a biopsy, have it conducted by an expert trained in Barrett’s esophagus diagnosis and treatment, like we have at Fort Sanders Regional,” Panjehpour said. “Today we have a totally new way of managing those patients, with no mortality. And if esophageal cancer is caught at an early stage, it is curable.”