Photodynamic therapy (PDT)

Photodynamic therapy (PDT) is a treatment that involves the use of light-sensitive medication and a light source to destroy abnormal cells.

It can be used to treat some skin and eye conditions, as well as certain types of cancer.

On their own, the medication and light source are harmless, but when the medication is exposed to the light, it activates and causes a reaction that damages nearby cells.

This allows small abnormal areas of tissue to be treated without the need for surgery.

Uses for PDT

PDT can be used to treat abnormal cells in parts of the body a light source can reach, such as the skin, eyes, mouth, oesophagus (gullet) and lungs.

Conditions sometimes treated with PDT include:

• actinic keratoses – dry, scaly patches of skin caused by damage from years of sun exposure that could become cancerous if not treated
• Bowen's disease – a very early form of skin cancer
• basal cell carcinoma – a type of skin cancer
• macular degeneration – an eye condition that can lead to vision loss
• Barrett's oesophagus – changes in the cells in the lining of your lower oesophagus that could become cancerous if not treated
• oesophageal cancer, mouth cancer and lung cancer – PDT can cure some cancers if used in the early stages, or offer relief from symptoms in more advanced cases

PDT also shows promise in treating some other types of cancer, as well as warts, acne and extramammary Paget's disease (a pre-cancerous condition that affects skin in and around the groin).

What happens during PDT

PDT is carried out in two stages.

1) Preparation

• First, you'll need to come into the hospital or clinic to be given the light-sensitive medication.
• Depending on the area of the body being treated, the medication may be a cream, injection or special drink.
• Once the medication has been applied or given, you may be asked to go home and return in a few hours or days – this will give the medication a chance to build-up in the abnormal cells.

2) Light treatment

• Later, you'll need to return to the hospital or clinic for the light treatment.
• This will involve a lamp or laser being shone on to the treatment area for around 10 to 45 minutes.
• To treat abnormal cells inside your body, such as in your lungs, an endoscope (flexible tube) will be passed into your body to deliver the light.
• Sometimes a local anaesthetic may be used to numb the treatment area or you may be given medication to help you relax during the procedure.

After PDT

If your skin was treated, it'll be covered by a dressing that should remain in place for about a day. Your care team will tell you exactly how long.

Try to avoid scratching or knocking the treated area, and keep it as dry as possible.

Once you're advised to remove the dressing, you can wash and bathe as normal, as long as you gently pat the treated area dry.

A follow-up appointment at the hospital or clinic will be arranged to assess whether the treatment has been effective and decide if it needs to be repeated.

It usually takes around 2 to 6 weeks for the area to heal completely, depending on which part of the body has been treated and how big the area is.

Risks and side effects of PDT

PDT is a very safe treatment, although the following side effects are common:

• a burning or stinging sensation while the light treatment is carried out – this usually passes soon after the treatment finishes
• if the medication was injected, your skin or eyes being sensitive to sunlight and bright indoor lights for up to 6 weeks – speak to your care team about things you should do to protect your eyes and skin during this time

Other potential side effects depend on the area treated.

• If your skin is treated, it may become red, swollen or blistered for a few days and have a scabby crust for a few weeks. Occasionally, it may become slightly darker or lighter and there may be some hair loss. This is usually temporary, but can sometimes be permanent.
• Treatment of the mouth, oesophagus and lungs can cause coughing, coughing up blood, difficulty swallowing, painful breathing or breathlessness. This is usually temporary.
• If your eyes are treated, there's a very small risk of permanent vision loss.

Talk to your doctors about the possible risks of PDT before having the treatment.

NGPDT and sonodynamic therapy

PDT is an effective and licensed treatment for a number of conditions.

It shouldn't be confused with the unproven, unlicensed versions sold by some private clinics in the UK and overseas.

Clinics promoting these so-called "advanced" versions of PDT, called "next-generation PDT" (NGPDT) and "sonodynamic therapy" (SDT) sometimes claim they can treat deep or widespread cancers.

But these claims aren't supported by scientific evidence and these treatments aren't recommended, even as a last resort.