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Dr. Charles Loewe: Case 1
High anxiety and difficulty swallowing
Listen to how Dr. Loewe leveraged TissueCypher to upstage treatment for a highly anxious patient with a long history of GERD and recent trouble swallowing.
“[The patient] said to me: ‘Are you going to do anything with my Barrett’s at this time’…I said, ‘TissueCypher will give us that answer to lower your anxiety.’ ”
Clinical risk factors
74-year-old, white male
A 74-year-old male patient with a long history of GERD presented to Dr. Loewe with difficulty swallowing. Previous surveillance endoscopies from 3 years prior showed non-dysplastic Barrett’s esophagus.
Endoscopic findings
The endoscopy confirmed the presence of long-segment non-dysplastic Barrett’s esophagus by both traditional pathology and WATS3D.
Lower esophagus:
- BE segment: C4M5
- 2 cm hiatal hernia
- Non-dysplastic pathology
- WATS3D-confirmed NDBE
Traditional Management:
- Clinical profile: Low risk due to NDBE
- Treatment recommendation: 3-5 yr surveillance
From top left to bottom left: Oropharynx, Barrett's esophagus, Barrett's esophagus, Hiatal hernia
TissueCypher results
TissueCypher results showed an intermediate-risk classification with a 5-year risk of progression of 7%, approaching the progression risk of confirmed low-grade dysplasia. Through shared decision-making, Dr. Loewe and the patient opted to remove the precancerous tissue using Endoscopic Eradication Therapy (EET).
- Risk class: Intermediate
- Risk score: 5.5
- 5-year risk of progression: 7%
TissueCypher-guided management
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Change in management: upstaged due to shared decision making
"Using shared decision making, [the patient] said to me 'I want you to get rid of that cancer risk'... and we proceeded with endoscopic eradication therapy."
Charles Loewe, MD