Sylvester Comprehensive Cancer Center

UM/Sylvester Introduces New Photodynamic Therapy

04.05.2004

The University of Miami Sylvester Comprehensive Cancer Center is pleased to offer photodynamic therapy for some patients being treated for esophageal and lung cancer, a treatment which was not available in South Florida before now. This non-invasive treatment uses light to treat shallow tumors in sensitive areas of the body, which are difficult to reach with conventional surgery. “Cancer often starts on the surface before it grows deep in the mouth or throat,” said Francisco Civantos, M.D., F.A.C.S., a head and neck surgeon at UM/Sylvester. “The advantage of photodynamic therapy is, you shine the laser at the tumor and it can heal malignant cells in one shot.”

Patients are injected with a light-sensitizing medication, Photofrin (porfimer sodium), to prepare for the treatment, which makes the entire body highly light-sensitive. Then two days later the patient returns for a controlled light exposure with a non-thermal laser. An endoscope is used to exactly position the treatment device, which comes in multiple sizes from one to nine centimeters long for treating tumors of different lengths.

The actual device is a portable, 43 lb., 120-volt system. It is fully programmable to automatically deliver the exact dosage at the right duration depending on the severity and location of the tumor. Unlike conventional surgery, this device is ideal for treating surface lesions in sensitive areas like the esophagus and lungs. Photodynamic therapy offers patients a tissue-preservation option in these vital organs. “For patients who have had multiple tumors, photodynamic therapy can preserve function and preserve the ability to chew and swallow,” said Civantos.

PDT is a laser treatment in the red spectrum of light, but unlike skin cancer treatments and other therapeutic laser treatments, this is a non-thermal treatment. PDT does not burn the tumor tissue with heat and it is the only non-thermal laser treatment approved by the FDA for phase I dysplasia. “We can use this technique to eradicate dysplasia, which is early superficial cancer, in Barrett’s esophagus, a condition that can be associated with gastrointestinal reflux disease, or GERD,” said Jeffrey Raskin, M.D., interim chief of the Division of Gastroenterology at the University of Miami School of Medicine. “Normally we can treat people in one session in about an hour.”

Therapy with PDT usually involves treatment over one or two days, depending on the needs of the patient. A single treatment will range from 8 minutes up to 12 ½ minutes, and three areas can be treated in one session. If, for example, a patient has a long area needing treatment along the esophagus, the surgical team could administer treatment in three stages, with the procedure complete in about an hour. Patients return home shortly after the therapy on the same day as their treatment.

Because Photofrin is a systemic treatment, PDT patients will be highly sensitive to sun exposure for up to six weeks after their injection. Patients treated with PDT at UM/Sylvester get a detailed information kit which includes a training video, explicit instructions on how to dress and behave when outside, and in some cases, a supply bag which includes a hat, gloves, brochures, the video, and more. Treatment with photodynamic therapy is covered by most insurance companies for approved treatments like those offered at UM/Sylvester, and the equipment manufacturer also offers needs-based financial assistance.

“We used to have to refer patients elsewhere for this treatment,” said Civantos. “Now we can treat them right here in South Florida.” The acquisition of this new technology was made possible by the generosity of George Rosenfield, who made a donation in the name of longtime friend Jerome Taft. “We had a fifty year relationship with Jerome and his wife Bea and their children,” said Rosenfield. “It was just a real love affair and we were party to the suffering when he had his operation and treatment.” Taft passed away three years ago after a struggle with esophageal cancer. The Rosenfields made it their mission to do something to help patients with the same disease. In addition to making PDT available, they are now supporting an expansion of the gastroenterology area of UM/Sylvester.

UM/Sylvester was founded in 1992 to provide comprehensive cancer services and today serves as the hub for cancer-related research, diagnosis, and treatment at the University of Miami School of Medicine. UM/Sylvester handles more than 1,100 inpatient admissions annually, performs 2,800 surgical procedures, and treats 2,900 new cancer patients. All UM/Sylvester physicians are on the faculty of the University of Miami School of Medicine, South Florida’s only academic medical center. In addition, UM/Sylvester physicians and scientists are engaged in 150 clinical trials and receive more than $30 million annually in research grants. UM/Sylvester at Deerfield Beach recently opened to better meet the needs of residents of Broward and Palm Beach Counties. This 10,000 square-foot facility at I-95 and S.W. 10th Street offers appointments with physicians from six cancer specialties, complementary therapies from the Courtelis Center, and education and outreach events.

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