Inclusion Criteria:

- High Grade-IMCancer:

- Diagnosis of Barrett's esophagus and high-grade dysplasia or intramucosal
carcinoma

- Deemed inoperable based on the following criteria: co-morbid conditions such as
severe heart, lung, kidney or liver disease; or refusal of surgical intervention
after a thorough discussion of the highly experimental nature of cryotherapy

- CT scan of the chest and abdomen with oral and intravenous contrast (unless
allergic), demonstrating no evidence of advanced esophageal cancer (extension
into or through the wall or lymph node involvement)

- Endoscopic ultrasound evaluation demonstrating no evidence of metastatic lymph
node involvement or extension of carcinoma beyond the mucosa

- Pathology review of esophageal biopsies by two independent reviewers, including
at least one from the Department of Pathology at the University of Maryland, to
confirm the diagnosis of Barrett's esophagus with HGD and/or IMCA

- Presentation and discussion at Thoracic Tumor Board

- Mucosal/submucosal cancer:

- Diagnosis of esophageal carcinoma

- Deemed inoperable based on the following criteria: co-morbid conditions such as
severe heart, lung, kidney or liver disease; or refusal of surgical intervention
after a thorough discussion of the highly experimental nature of cryotherapy

- CT scan of the chest and abdomen with oral and intravenous contrast (unless
allergic), demonstrating no evidence of advanced esophageal cancer (extension
through the wall or lymph node involvement)

- Endoscopic ultrasound evaluation demonstrating no evidence of metastatic lymph
node involvement and primary lesion extending into submucosa or muscularis
propria (T1smN0 or T2N0)

- Presentation and discussion at Thoracic Tumor Board

- Patients who have undergone previous ablation therapies are eligible for this
study.

- Severe squamous dysplasia:

- Diagnosis of severe dysplasia within esophageal squamous mucosa

- Deemed inoperable based on the following criteria: co-morbid conditions such as
severe heart, lung, kidney or liver disease; or refusal of surgical intervention
after a thorough discussion of the highly experimental nature of cryotherapy

- CT scan of the chest and abdomen with oral and intravenous contrast (unless
allergic), demonstrating no evidence of advanced esophageal cancer (extension
into or through the wall or lymph node involvement)

- Endoscopic ultrasound evaluation demonstrating no evidence of metastatic lymph
node involvement or extension of carcinoma beyond the mucosa

- Pathology review of esophageal biopsies by two independent reviewers, including
at least one from the Department of Pathology at the University of Maryland, to
confirm the diagnosis

- Presentation and discussion at Thoracic Tumor Board

Exclusion Criteria:

- Age less than 18 years

- Co-morbid illness expected to cause death within 6 months

- Pregnancy

- Medically unfit or other contraindication to tolerate upper endoscopy

- Inability to tolerate therapy with a proton pump inhibitor (PPI)

- Refusal or inability to give consent