Raman Spectroscopy: Twenty-five years of concept to clinical application for early diagnosis of pre-cancer in Barrett’s Oesophagus

Early diagnosis and treatment of all diseases and in particular cancer is important to allow curative treatment. Symptomatic
cancer is usually a lethal disease that requires extensive treatment that is enormously challenging for the patient. Over
some twenty-five years we have explored the use of Raman to detect molecular changes in precancerous change and
cancer of the oesophagus. The aims have been to reduce the subjectivity of histological diagnosis in particular of dysplastic
pre invasive cancerous changes in columnar lined (Barrett’s Oesophagus). These changes are often macroscopically
invisible and very easily undetectable. Following this we have investigated the development of rapid diagnostic techniques
to detect early degeneration in real time without the delays inherent in biopsy and histological analysis. In particular,
we have concentrated on the early detection of the macroscopically invisible changes that precede the degeneration
to cancer in some patients with Barrett’s Oesophagus. Once these changes are detected the area can we treated using
endoscopic techniques and the progression to cancer interrupted without major and life threatening interventions.