Humber River Regional Hospital (HRRH) is about to become Ontario’s first non-teaching hospital to use the Ultrasonic Gastrofiberscope for diagnosing and treating cancer of the esophagus, stomach, pancreas and colon. By using this relatively new and advanced technology physicians can investigate, diagnose and, in many cases, treat cancer patients without surgery. When used in conjunction with a radio ultrasound, this device makes it possible to perform a relatively new procedure known as endoscopic ultrasonography (EUS).
HRRH Gastroenterologist Dr. T. Ptak, first introduced the procedure to the hospital three years ago and has championed its introduction to hospitals across the province and lectured on the subject internationally.
Physicians at non-teaching hospitals currently rely on the radio ultrasound machine as their primary diagnostic tool, which limits their diagnosis and treatment options. But the ultrasonic gastrofiberscope, operating like a radar machine sends out radio waves through tissue and performs at a higher frequency and produces higher resolution images.
Ptak explains that the device allows physicians to see in minute detail not only the tumour, but also the exact amount of tissue invasion. Tumours as small as a few millimetres can be accurately assessed to a degree not possible by any other technique including CT scans and magnetic resonance imaging (MRI) machines.
He says: “This technology makes it possible to diagnose cancer of the esophagus, stomach or colon in the early stages. We will now have the capability to perform an EUS, which offers several benefits to patients. For example, the various stages of cancer can now be determined using a fine needle aspirator that samples small lesions up to 2 mm in size. Before now, this procedure could only be performed using surgery. If necessary, patients can be offered therapeutic treatment because we are able to perform biopsies and inject and drain cancerous cells.”
Dr. Ptak lauds this technology as a great means of improving patient care by offering oncologists more accurate and comprehensive diagnoses and the option of performing an array of therapeutic procedures. For example, Ptak says he and his colleagues, “will have the capability to diagnose pancreatic cancer in its early stages.” None of the other diagnostic tools like the MRI or CT scan are capable of doing this. He explains that, “a physician’s ability to determine the stage of the cancer plays a critical role in deciding the treatment strategy chosen for a patient and the outcome of treatment.”
Many patients will stave off unnecessary surgery that, in the past, has been performed and then found to be of no benefit because the cancer is so far advanced. This technology will save many lives and result in tremendous cost savings with the decline in the number of unnecessary surgeries. The cost of the equipment is $380,000 and can be used with minimal risk to patients. While it has been widely available to most oncologists in Europe and the United States since 1986, this has not been the case in Ontario.
Considering that colorectal cancer ranks second in men and women as the most common cause of cancer death, the returns on this investment will be tremendous without even factoring in its benefits for other cancers.