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Photodynamic Therapy

Your doctor has recommended photodynamic (FOE-toe-die-NAM-ik) therapy (PDT) for you. PDT is a two-step process that treats advanced esophageal (ee-SOF-uh-GEE-ul) and lung cancer. While this is a relatively new procedure, physicians at UPMC Presbyterian have been using it since 1996.

Today UPMC Presbyterian and UPMC Shadyside are the most active centers in the world using PDT for esophageal and lung cancers. PDT combines a light-sensitive drug and a laser light to destroy cancer cells. The drug used is porfimer sodium, brand name Photofrin.

Photofrin injection

First, you will receive the injection of Photofrin. Photofrin helps make tumors more sensitive to the laser treatment. The injection will be given intravenously (in-tra-VEEN-us-lee), or into the vein, through your arm. It will take ten minutes. This first step usually occurs in the hospital. The doctor will monitor you for 30 minutes after the injection.

Skin care after injection

After the injection, you will be photosensitive (FOE-toe-SEN-suh-tiv), or sensitive to sunlight and bright light, such as the light from high-intensity reading lamps or sunlamps. All your skin will be at high risk for severe sunburn, swelling, and possible blistering if exposed to sunlight. This sun sensitivity usually lasts four to six weeks. You should avoid direct sunlight, even light through a window. Sunscreen and sunblock will not prevent sunburn after your injection.

Remember, normal overhead lights and light from a television will not cause you problems. Brief exposure to sunlight is acceptable if proper attire is worn and precautions are taken.

Bring protective clothing on the day of your injection. The clothing should be made of dark, tightly woven fabrics. Bring a longsleeved shirt, long pants, a wide-brimmed hat or scarf, gloves, and sunglasses. If you are not properly protected, sunburn may occur, even on overcast days. You must have someone drive you home on the day of your injection, so you can sit in the back seat, away from sunlight. If mild sunburn does occur, you may use cool compresses and aloe vera gel. Call your nurse or doctor if you are not sure about the severity of your sunburn.

Laser treatment

Your laser treatment will be given within one to two days after your Photofrin injection. This procedure will be done in the operating room. You will be given medicine to relax you, but you will remain awake. If no problems occur after the treatment, you will be discharged the same day. Laser treatment is delivered to the esophagus or the lungs through a scope, or tube, inserted into your mouth.

Tumors of the esophagus

The esophagus (eh-SOF-uh-gus) is the long tube that extends from your mouth to your stomach. Esophageal tumors can block your throat, making it hard for you to swallow. PDT helps relieve this blockage.

The laser light will be delivered to the tumor through a gastroscope. A gastroscope is a lighted tube that is inserted through the mouth to view the esophagus and stomach. This entire treatment will take about 30 minutes.

Lung tumors

PDT can be used to treat lung tumors in the airway or other areas easy to reach with a bronchoscope (BRONK-oh-scope). A bronchoscope is a lighted tube used to view the trachea (TRAY-key-uh), or windpipe, and the bronchi (BRONK-eye), or airways connecting the lungs and trachea. The bronchoscope is inserted through the mouth. During the procedure, the bronchi and trachea are examined and tumors are treated with the laser light. This procedure will take about 15 minutes.

Cleanup

Both the esophageal and lung PDT treatments require a second laser procedure. This procedure “cleans up” by removing the dead cells. Cleanup helps improve swallowing and breathing. This second laser procedure is usually done one to two days after the PDT treatment.

If you are admitted

Sometimes patients are admitted to the hospital after the laser treatment. Your doctor will decide if this is necessary in your case. A hospital stay after PDT is usually 24 hours.

Discharge

When you are discharged from the hospital, you will be given medication to help relieve any pain or discomfort you may have. Discomfort after treatment often includes a burning sensation in the chest. A dietitian will talk with you about your special dietary needs. Your follow-up appointment will be made at this time.

If you have any questions or concerns, please feel free to call your doctor or nurse.


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