As an interventional endoscopist specializing in oncology, Neil Sharma, MD, president of Parkview Cancer Institute and a member of Parkview Physicians Group, often finds himself delivering difficult information to patients. With the help of continual research and the innovative use of technology, however, the treatment options have not only become less intimidating, they can also dramatically improve outcomes.
Since the mid-1970s, esophageal cancer rates have risen dramatically; a nearly 600-fold increase has made it the fastest-growing cancer in the United States. While traditional treatments generally involve radiation, chemotherapy and major surgery that requires the removal of part or all of the esophagus, new methodologies offer less invasive options that often yield better results if the disease is found in early stage. That’s where Dr. Sharma comes in.
The key, believes Dr. Sharma, is to embrace disruptive therapies, methods that can arrest the development of disease very early in its life cycle.
“Can we disrupt a cancer before it becomes a cancer?” asks Dr. Sharma. “It’s a matter of technology being able to catch up with the vision to do things like that. We are able to detect pre-cancerous cells and early stage cancers and remove them from the esophagus and other organs using this new technology, leading to less invasive and less costly treatments.”
For example, Dr. Sharma uses interventional endoscopy not only to identify cancerous and pre-cancerous cells, but also to remove them. Rather than using a scope simply to look inside a person, the methodology also uses the scope to guide treatment.
“We can identify pre-cancerous cells and early stage invasive cancers and remove them from the inside out,” explains Dr. Sharma. “What used to require a week in the hospital now can be just an overnight stay, and sometimes even less.”
Like standard endoscopy, surgical or advanced interventional endoscopy involves inserting a scope through the mouth. By adding three-dimensional ultrasound technology, the physician can see the area more precisely. If abnormal cells are detected, he can insert a needle to remove them for laboratory identification and verification of diagnosis. When cancer or pre-cancer is confirmed, the physician inserts a heater probe to burn off the cells. The procedure requires no incisions and can be undertaken much earlier than traditional treatments, improving both the recovery time and the overall outcome.
Dr. Sharma performed the first two such procedures for pancreatic neuroendocrine cancer in the Midwest, and after more than a year, the results remain extremely promising. Neither patient has shown further signs of cancer.
Parkview is one of only three facilities of its size nationally to land a clinical research fellowship for surgical endoscopy. Ultimately, the work done through this fellowship will draw others into the field, drive new technologies, and impact care throughout the country. Through the support of the Parkview Mirro Center for Research and Innovation, Parkview’s interventional endoscopy program had 18 scientific and clinical publications in 2017, placing cancer care and surgery in Fort Wayne on the national stage.
As technologies and treatments evolve, part of the process includes educating providers and patients on the growing number of options. To that end, Parkview has created a number of videos with animated voice-overs to help people understand procedures like surgical endoscopy.
“The field is always growing and changing,” says Dr. Sharma. “We have a big responsibility that, as we’re doing these things, we are also educating people.”
It is equally important to communicate with device manufacturers so they can understand what tools might make a difference. By sharing ideas and helping them understand needs, they can design more effective instruments.
As critical as technology is to treatment, it still takes people to drive progress and deliver care.
“A holistic approach to healing always works best,” says Dr. Sharma. “Everyone is equally important – providers, nurse practitioners, social workers – they just have different roles.”
No matter what the role, effective healing starts with making the right diagnosis and choosing the most effective treatment. That, says Dr. Sharma, requires innovative thinking that embraces technology, staying abreast of ever-evolving treatment options, and keeping an open mind.
“Innovations in medicine can change outcomes,” emphasizes Dr. Sharma. “Even though we’ve seen an increase in the number of devices and a more significant role for surgical endoscopy, we should never fall into the trap of thinking certain tools are the best.”
Each new idea, each innovation, and each new treatment mean that when physicians like Dr. Sharma have to deliver a troubling diagnosis, they can also offer an increasing sense of hope for a good outcome.
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