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Lasers in Cancer Treatment

The word LASER stands for Light Amplification by Stimulated Emission of Radiation.

Laser light is different from regular light. The light from the sun or from a light bulb has many wavelengths and spreads out in all directions. Laser light, on the other hand, has a single wavelength and can be focused in a very narrow beam. This makes it both powerful and precise. Lasers can be used instead of blades (scalpels) for very careful surgical work, such as repairing a damaged retina in the eye or cutting through body tissue.

Types of lasers

Lasers are named for the liquid, gas, solid, or electronic substance that’s used to create the light. Many types of lasers are used to treat medical problems, and new ones are being tested all the time. Today, 3 kinds of lasers are commonly used in cancer treatment: carbon dioxide (CO2), argon, and neodymium: yttrium aluminum garnet (Nd:YAG).

Carbon dioxide (CO2) lasers

The CO2 laser is mainly a surgical tool. It can cut or vaporize (dissolve) tissue with fairly little bleeding as the light energy changes to heat. This type of laser is used to remove thin layers from the surface of the skin without going into the deeper layers.

Argon lasers

The argon laser only goes a short distance into tissue. It’s useful in treating skin problems and in eye surgery. It’s sometimes used during colonoscopies (tests to look for colon cancer) to remove growths called polyps before they become cancer. It can be used with light-sensitive drugs to kill cancer cells in a treatment known as photodynamic therapy (PDT). (You can learn more about this in our document titled Photodynamic Therapy

Nd:YAG (Neodymium: Yttrium-Aluminum-Garnet) lasers

Light from this laser can go deeper into tissue than light from other types of lasers, and it can make blood clot quickly. Nd:YAG lasers can be used through thin flexible tubes called endoscopes to get to hard-to-reach parts inside the body, such as the swallowing tube (esophagus) or large intestine (colon). This light can also travel through optical fibers, which can be bent and put into a tumor to heat it up and destroy it.

Other lasers used in medicine

Some newer types of lasers – the erbium: yttrium aluminum garnet (Er:YAG); holium: yttrium aluminum garnet (Ho:YAG), copper vapor, and diode lasers – are also being used in medical and dental treatments.

Pros and cons of laser surgery

Lasers have some advantages (pros) and disadvantages (cons) compared with standard surgical tools.

Pros of laser surgery

Cons of laser surgery

Treating cancer with lasers

Lasers can be used in 2 ways to treat cancer:

Though lasers can be used alone, they are most often used with other cancer treatments, such as chemotherapy or radiation.

Lasers are also being studied for treating or preventing side effects of common cancer treatments. For instance, some studies are looking at how low-level laser therapy (LLLT) might be used to prevent or treat severe mouth sores caused by chemotherapy, and how they may be used to treat the swelling (lymphedema) that can result from breast surgery.

Shrinking or destroying tumors directly

The CO2 and Nd:YAG lasers are used to shrink or destroy tumors. They can be used with thin, flexible tubes called endoscopes that let doctors see inside certain parts of the body, such as the bladder or stomach. The light from some lasers can be sent through an endoscope fitted with fiber optics. This lets doctors see and work in parts of the body that could not be reached otherwise except by major surgery. Using an endoscope also allows very precise aim of the laser beam.

Lasers can be used with low-power microscopes, too. This gives the doctor a larger view of the area being treated. When used with an instrument that allows very fine movement (called a micromanipulator), laser systems can produce a cutting area as small as 200 microns in diameter – that’s less than the width of a very fine thread.

Lasers are used to treat many kinds of cancer. In the intestines or large bowel, lasers can be used to remove polyps, small growths that might become cancer. The CO2 laser can be used to treat pre-cancerous tissue and very early cancers of the cervix, vagina, and vulva.

Lasers are also used to remove tumors blocking the swallowing tube (esophagus) and large intestine (colon). This does not cure the cancer, but it relieves some symptoms, such as trouble swallowing.

The Nd:YAG laser has also been used to remove cancer that has spread to the lungs from other areas. This helps avoid surgery that would require removing large sections of lung. This type of laser cannot cure cancer, but it can improve breathing and other symptoms in many patients.

Cancers of the head, neck, airways, and lungs can be treated (but usually not cured) with lasers. Small tumors on the vocal cords may be treated with lasers instead of radiation in some patients. Tumors blocking the upper airway can be partly removed to make breathing easier. Blockages deeper in the airway, such as in the branches of the breathing tubes (bronchi), can be treated with a flexible, lighted tube called a bronchoscope and an Nd:YAG laser.

Laser-induced interstitial thermotherapy (LITT) uses heat to help shrink tumors by damaging cells or depriving them of the things they need to live (like oxygen and food). In LITT, the laser light is passed through a fiber optic wire and right into a tumor, where it heats up, damaging or killing cancer cells. LITT is sometimes used to treat tumors in the liver.

Photodynamic therapy

In photodynamic therapy (PDT), a special drug called a photosensitizing agent is put into the bloodstream. Over time it is absorbed by body tissues. The drug stays in cancer cells for a longer time than in normal tissue. Shining a certain kind of light on the cancer cells that have the drug in them “turns on” the drug, which then kills the cancer cells.

Photosensitizing agents are turned on or activated by a certain wavelength of light. For example, an argon laser can be used in PDT. When cancer cells that contain the photosensitizing agent are exposed to red light from this laser, it causes the chemical reaction that kills the cancer cells. Light exposure must be carefully timed so that it’s used when most of the agent has left healthy cells, but is still in the cancer cells.

PDT has some advantages over other treatments:

Still, PDT as it’s currently used is not without its problems. Argon laser light cannot pass through more than about 1 centimeter of tissue (a little more than one-third of an inch), which means it’s not useful against deeper tumors. And the photosensitizing agents used today can leave people very sensitive to light, causing sunburn-like reactions after only very brief sun exposure. This can greatly limit the patient’s activities until the body gets rid of the drug, which often takes weeks.

PDT is sometimes used to treat cancers and pre-cancers of the swallowing tube (esophagus), and certain kinds of lung cancer that can be reached with endoscopes. PDT is being studied for use in other cancers, such as those of the brain and prostate. Researchers also are looking at different kinds of lasers and new photosensitizer drugs that might work even better.

Last Medical Review: 07/23/2013
Last Revised: 07/23/2013

Referenced from American Cancer Society (cancer.org)