What is photodynamic therapy?
How does photodynamic therapy work against cancer?
Why can't I just take the drug?
Does the laser light burn?
How does the doctor administer the laser light?
Is the procedure painful?
What are the possible side effects?
What precautions should I take to prevent a photosensitivity reaction?
Will sunscreens protect me?
When do I no longer need to take precautions?
How will I know if I've had a reaction and what should I do?
What preparations should I make before going in for the injection?

Q. What is photodynamic therapy?
A. Photodynamic therapy is a treatment now being used in patients with certain types of cancer. PDT uses a combination of a drug that is activated by light and light from a laser. Both work to allow the doctor to specifically target and destroy cancer cells while limiting damage to surrounding healthy tissue. Top
Q. How does photodynamic therapy work against cancer?
A. First, you will be given an injection of the photoactive drug Photofrin® (porfimer sodium). Photofrin will be absorbed by your body's tissues, including cancer tissue.
Over the next couple of days, the drug will largely be eliminated from most healthy tissue. However, it will remain in cancer cells.
About 40 to 50 hours after the Photofrin injection, light from a laser will be directed at the cancer cells. The application of light takes about 5 to 40 minutes depending on the amount of tumor your doctor wants to treat. For many patients the entire procedure takes less than one hour.
The light will activate the drug present within those cells and destroy them. Because Photofrin is retained to a greater degree by cancer cells than by healthy cells, most of the healthy tissue surrounding the treated area will not be affected. Top
Q. Why can't I just take the drug?
A. Neither the drug nor the laser light alone can destroy the cancer cells - they must be used in combination. That's because the drug must be activated by the laser light before it can destroy the cancer cells. Top
Q. Does the laser light burn?
A. The low-powered light used in photodynamic therapy does not burn. Top
 Q. How does the doctor administer the laser light?
A. The doctor will direct the laser light to its target through a fiber optic. Fiber optics that are specially designed to conduct laser light are thin, flexible, transparent strands, something like fishing lines.
In treating esophageal cancer the fiber optic is passed down the throat through an endoscope (a thin tube that is placed down your throat). If the treatment is for lung cancer the fiber optic is passed through a bronchoscope. Top
Q. Is the procedure painful?
A. With this procedure, a sedative is given along with local or general anesthesia, so you should feel little or no discomfort during the procedure. Top
Q. What are the possible side effects?
A. There are three major side effects associated with photodynamic therapy.
First, local swelling and inflammation occurring in and around the treated area may cause physical discomfort including pain in the chest, back, or abdomen and breathing difficulties.
A second major side effect is photosensitivity due to the continued presence of the drug in the skin.
Thirdly, if your esophagus is being treated, there is a possibility of stricture formation (esophageal narrowing) which may require dilation by your doctor. This means that from the moment you receive your Photofrin injection - and for at least 30 days thereafter - your skin and eyes will be very sensitive to bright light.
Exposure to bright light or direct sunlight should therefore be avoided to prevent sunburn, redness and swelling. Photosensitivity reactions can occur in minutes, so it is extremely important to take precautions to shield your skin and eyes from exposure.
Other fairly common side effects include the following if your esophagus is being treated: pleural effusion (fluid around the lung), strictures (esophageal narrowing), fever, nausea and/or vomiting, constipation, pain in the chest or abdomen, dehydration, difficulty breathing, difficulty swallowing, anemia, headache, or hiccups.
They include the following if your lung is being treated: Pain in the chest, constipation, shortness of breath, hemoptysis (coughing up small amounts of blood), fever, coughing, pneumonia, bronchitis, fatal hemoptysis, obstruction (mucus plug), edema, and stricture (narrowing). Talk with your doctor about what you can expect. Top
Q. What precautions should I take to prevent a photosensitivity reaction?
A. You must be careful for at least 30 days after your injection to avoid bright lights and direct sunlight. Some patients may remain photosensitive for up to 90 days. You don't have to limit yourself to dark rooms however, either in the hospital or once you are back home. In fact, it's important to get some indoor light, because low levels of light will help break down the drug in your skin and make you less photosensitive.
The lighting in your home should not be a problem, but do stay away from direct sunlight, skylights or undraped windows.
Most indoor activities are fine including watching television. (You can also go to the movies or live theater.) When reading, do not expose your skin to the light from a reading lamp - keep your skin covered.
If at all possible, wait until sundown to do daily chores like shopping.
If you go out during daylight hours, you must cover as much skin as possible. That means wearing a long-sleeved shirt, slacks, gloves, socks, shoes and a wide-brimmed hat. Wear tightly woven, light-colored fabrics, if possible.
You should also protect your eyes by wearing dark sunglasses (less than 4 percent white light transmittance). It is important for you to wear protective clothing and sunglasses even on cloudy days and while in a car.
For at least 30 days after the injection, stay away from bright examination lights such as those found in a dentist's office, and "helmet"-type hair dryers like those found in beauty salons, as they can cause skin burns. Handheld hair dryers at low settings are a safer option. Top
Q. Will sunscreens protect me?
A. No. Sunscreens will not protect against photosensitivity, no matter how high the SPF, because sunscreens protect against ultraviolet (UV) light. Photoactivation is caused by visible light, not UV light, which is invisible. Top
Q. When do I no longer need to take precautions?
A. The duration of photosensitivity differs from person to person. After the first 30 days you should do a test by exposing a small portion of skin - maybe the back of your hand or arm - to sunlight. One way is to cut a hole (about 2 inches) in a paper bag that you can put your hand into. Expose the unprotected patch to sunlight for 10 minutes. If a photosensitivity reaction (swelling, redness, or blistering) occurs within 24 hours of exposure, continue to take precautions for another 2 weeks before retesting. If no reaction occurs within 24 hours of exposure, you may gradually increase your exposure to sunlight.
Continue to watch for any reaction as some patients may remain photosensitive for 90 days for more. Limit your time outdoors between 11 a.m. and 2 p.m., when the sun is strongest. Avoid using your face to test for photosensitivity. Top
Q. How will I know if I've had a reaction and what should I do?
A. A photosensitivity reaction will look like a bad sunburn. Your skin will appear red and swollen. Just as with a sunburn, there may be some blistering. If you see that you've experienced a reaction, call your doctor at once. He/she will be the best guide as to how to treat it. Top
Q. What preparations should I make before going in for the Photofrin injection?
A. Check your home to be sure you have adequate shades or curtains on windows that would otherwise expose you to sunlight. And remember to bring sunglasses, gloves and a hat with you to the hospital when you first go in for treatment. Top