Together we will beat cancer

Dr Rebecca Fitzgerald

Dr Rebecca Fitzgerald is running a large-scale clinical trial testing the cytosponge.

A couple of years ago we wrote about a revolutionary new technique being developed for detecting oesophageal cancer – the cytosponge, or ‘sponge on a string’ test –  presented by Dr Rebecca Fitzgerald at the NCRI Cancer Conference in 2008.

Oesophageal cancer – which affects nearly 8,000 people a year in the UK – is notoriously difficult to treat if found late (which it usually is), so a way to detect it earlier could save many lives.

We’re delighted to announce that we’re now funding a large-scale trial of the cytosponge, called BEST2, recruiting up to 1,400 people across the UK. If the results are positive, the trial could pave the way for the widespread introduction of the test in the future.

The cytosponge test is designed to detect faulty cells that are the hallmark of a condition called Barrett’s oesophagus, which can lead to oesophageal cancer if left untreated. We’ve written in depth about the test in our earlier post but, to put it briefly, the test involves a person swallowing a small capsule on a string, which expands in their stomach over a few minutes to form a little sponge.

The sponge is then gently pulled back out, bringing a sample of cells with it as it comes up the person’s oesophagus (gullet). These cells are then tested in the lab for any signs of Barrett’s oesophagus or oesophageal cancer.

Here’s a video showing the ‘sponge on a string’ in action:

Although it sounds a bit icky (and watching the videos will probably make you gag in sympathy) the test is a significant step forward from the current method – endoscopy – which involves a camera on a tube being inserted down the person’s throat.

And not only is the cytosponge less invasive than an endoscope, it’s also significantly cheaper. Each sponge test costs just £25, compared with around £400 for an endoscopy.

This study couldn’t come at a better time. Rates of oesophageal cancer are rising in the UK, yet the disease still remains stubbornly difficult to treat if it is diagnosed at a late stage. Picking up the earliest signs of oesophageal cancer has the potential to make a big impact in survival, and if this can be done using a humble sponge then so much the better.




Karen Macpherson August 11, 2011

My Dad was diagnosed with Oesophageal cancer in December 2009 and I worry that I might get it too. I cant stand the idea of having an endoscopy, so I too would have this minimally invasive test carried out. So far Dad has recovered wee, following chemo and surgery, but life is not the same as before. Well done to you all. Karen

Glenn Local August 6, 2011

Hi Every one, every step forward is real progress, this is a terrible disease, that we must try to eradicate, & that is why I donate. Keep up the good work. Glenn

carole coote August 5, 2011

many thanks for the reply Kat, I will get back to the hospital. The last endoscapathy left me with burst blood vessels in and around my eyes and mouth so I don’t relish this procedure any more. The sponge sounds so easy.

WILLIAM RUSSELL August 5, 2011

This is a true improvement to the endoscopy process which I endured twice, once to detect the cancer, which lasted about 35 mins on the table and was not a pleasant experience, as anyone who has had it will testify, but luckily for me the second time was to confirm everything was Ok after surgery, and was about 2 mins as described prior to the first endoscopy. Best wishes to Geoff Lidster its a long road but worth it.

Faith Williams August 5, 2011

This is a great step forward for early detection, I lost my Mum to this particularly cruel cancer and it is a dreadful way to die. As mentioned by others I take Lanzaprazole daily for acid reflux.

Best of luck with future trials.

Judith McMullin August 5, 2011

I had an endoscopy in 2005, following a breast cancer diagnosis, and found it easier to tolerate than I had imagined. I was told that I had polyps and acid reflux, and have been taking Lanzaprazole ever since. I would really welcome the opportunity to take part in the trial with the “sponge on a string” as it sounds a far less invasive technique for making a diagnosis than the endoscopy!

Judith McMullin

Kat Arney August 5, 2011

Hi Anne, Margaret, Frederick, Geoff, Pat and Bruce,
Thank you all for your positive comments about the “sponge on a string” trial – we’re very excited about this study, and hope that it leads to a more effective way of screening in the future.
Thanks for reading our blog,
Best wishes,
Science Information Manager

anne bradshaw August 5, 2011

This is brilliant. I have always been fearful of having an endoscopy, although my sister has had one and says ‘Its nothing’. However i would give this sponge on astring some concideration. Keep up the good work

Kat Arney August 5, 2011

Hi Carole,

If you are concerned about the wait for your endoscopy, please talk to your GP or the Patients Advice and Liaison office at the hospital. You can also talk things through with our cancer information nurse team on freephone 0808 800 4040 any time between 9am and 5pm, Monday to Friday.

Best wishes,
Science Information Manager

margaret English August 5, 2011

i lost my husband last year to this dreadful cancer. It is a ghastly way to die and early diagnosis is the only way any one can survive. What a wonderful step forward i do hope it works. Good luck

Frederick Cox August 4, 2011

What a BRILLIANT idea!! Well done Cancer Research. I was diagnosed in 2006 the endoscopy was hard to bear this sounds much, much better. Ican’t afford to contribute much to you per month but it is money well spent. Thank you

Geoff Lidster August 4, 2011

I was diagnosed with Barretts a few years ago following an Endoscopy at A & E. As I have a metal aortic valve it wasn’t possible to take biopsies at that time due to my coagulation regime.
Two subsequent attempts at Endoscopies to obtain biopsies to confirm the visual evidence failed despite being in hospital for 10 days each time for transfer from warfarin to heparin and back. I was in such discomfort with the endoscopies that they were both aborted and no attempt to continue them was made. I’m therefore not receiving any monitoring of my condition, I’m just taking Lansaprozole to stop acid reflux. This simple test could be a potential life-saver for me. I can’t believe such a simple and obvious way of gathering cells from the bottom of the oesophagus didn’t occur to someone years ago. It’s wonderful news and I hope I get the opportunity to use it !!

carole coote August 4, 2011

I have Barretts and was supposed to have a 3rd endoscopathy in February the hospital just said they are running late with their lists and to wait. I didn’t know how bad this was til I read this report.. I am worried now and a bit scared. Carole

Pat MacRae. August 4, 2011

We lost our mum from this terrible cancer in 1993. She hated the endoscope. I truly hope this breakthrough saves lots of lives.
Pat Mac.

Bruce Mc Donald August 4, 2011

Marvellous. If you need any people to be guinea-pigs – I’m a volunteer. Bruce McD

surgical-blog July 27, 2011

Well lets hope that this program will be successful, These things should also be done by WHO.. Good Luck…….