'Pill on a string' could save thousands of lives with early cancer diagnosis

Scientists have developed a "pill on a string" which could save thousands of lives by achieving earlier diagnosis of one of the deadliest forms of cancer.

The soluble pill houses a small 'cytosponge', which researchers hope will improve prevention of oesophageal cancer by diagnosing a precursor disease known as Barrett's oesophagus.

The pill is swallowed whilst remaining attached to a piece of string. Upon entering the stomach, the multivitamin-sized pill dissolves to release a small sponge.

Five minutes later, the sponge is pulled back up the oesophagus by a nurse, collecting around a million cells from the gullet wall which can then be analysed for signs of Barrett's, a common precursor condition to oesophageal cancer.

According to Cancer Research UK, oesophageal cancer killed 400,000 people worldwide in 2012 and accounted for 5% of all cancer deaths in the UK in the same year. The UK has Europe's highest mortality rate for the disease, with a mortality rate of 21 people per day in 2012.

Professor Rebecca Fitzgerald, who developed the cytosponge, described it as being slightly smaller than a 50 pence piece. While she admitted the procedure might not be an entirely comfortable experience for the patient, she says it is a much safer and more efficient method than an endoscopy, which is how the cancer is most commonly diagnosed at present.

"Any of these diagnostic tests are never going to be 100% pleasurable, but an endoscopy is really not very nice - it's quite invasive and you have to go to the hospital. This is much quicker and you are at your GP's surgery. It's not pleasant and you're not going to want to do it every day but I think it's quite bearable," says Fitzgerald, of the Medical Research Council cancer unit at the University of Cambridge.

The research was originally published in the journal Nature Genetics.

An endoscopy involves feeding a small camera down the oesophagus to allow doctors to view the gullet wall and remove cells for analysis. Fitzgerald says the cytosponge could cost as little as £25 (€36), providing a much more cost-effective diagnostic method than endoscopies, which she says can cost up to £300 (€430).

Barrett's oesophagus is a consequence of acid reflux, when stomach bile comes back up the gullet. The condition results in the mutation of oesophageal cells and up to five in every 100 sufferers of Barrett's go on to develop oesophageal cancer.

Fitzgerald says that the cytosponge could potentially save thousands of lives by enabling early diagnosis of Barrett's, thereby expediting preventative treatment of patients at risk of developing oesophageal cancer.

"It's all about detecting it earlier. At the moment, a lot of patients with symptoms of heartburn and indigestion never get investigated, so we never find the people at risk because GPs can't be sending everyone off for an endoscopy," says Fitzgerald.

She hopes that the pill will be widely available in GP surgeries within five years.

Oesophageal cancer is largely the result of lifestyle factors, particularly smoking, with 66% of UK cases being linked to smoking. Obesity and excessive alcohol consumption are also significant risk factors, while a diet high in fruit and vegetables could protect against the disease.

Uncommon Knowledge

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Conor is a staff writer for Newsweek covering Africa, with a focus on Nigeria, security and conflict.

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