What is Endoscopic Oncology?
Endoscopic oncology refers to the use of advanced endoscopy techniques and imaging to help diagnose, stage, and treat cancer in different parts of the digestive (GI) tract. There are different types of methods an advanced endoscopist may employ to identify and/or excise pre-cancerous and early cancerous tissue.
Perhaps the most common intervention is the removal of pre-cancerous polyps from the colon during colonosocpy or other similar neoplastic lesions found during upper endoscopy procedure (EGD) but advances in this aspect of therapeutic endoscopy adapted from Japan have resulted in more sophisticated tools and expertise from advanced training which may be employed for:
- superficial GI neoplasms (pre-cancerous -dysplasia)
- early superficial cancer- (high-grade dysplasia superficial submucosa cancers)
- endoscopic mucosal resection (EMR)
- endoscopic submucosal dissection (ESD)
- Hybrid EMR/deep dissection technique
- endoscopic bridging interventions to definitive surgery or for palliation such as biliary, esophageal, enteral, and colon stents.
Additionally, pre-cancerous cysts of the pancreas can be evaluated by endoscopic ultrasound (EUS) and for some patients who are not candidates for surgery, special techniques to aspirate and ablate the cyst can be employed.
Working in partnership with the radiation oncologist, special gold markers (fidicuals) can be placed directly into tumors to guide targeted radiation treatment (Cyberknife therapy) and advanced endoscopic intervention by endoscopic ultrasound (EUS) guided injection of drugs to block the nerve causing pain in some patients with cancer of the pancreas.