Photodynamic therapy made simple

Photodynamic therapy has been approved in the United States for neoplasms in the esophagus and lung. The treatment is technically simple to apply but requires familiarity with the technique. The most important aspects are recognizing the appropriate indications and managing the potential toxicities of therapy. Photodynamic therapy uses a drug that causes neoplastic tissue to be sensitive to otherwise nonlethal visible light, which is generated by a laser and conducted to the tissue surface by optical fibers. Visible evidence of tissue damage is delayed, and the physician must be conscientious about light dosimetry. The treatment is currently thought to be effective in palliation of patients with esophageal cancer, eradication of early esophageal cancer, and ablation of Barrett's esophagus with high-grade dysplasia.