Chances of survival are higher for people diagnosed with early esophageal cancer.

November 19, 2014

It has long been known that esophageal cancer is one of the deadliest cancers.   Right now, due to lack of awareness, no standard or routine screenings and underfunded research, the outlook for esophageal cancer is grim.

While a diagnosis of esophageal cancer is daunting, especially when diagnosed in its later stages, the statistics that you will read below are not intended to predict individual outcomes and are only estimates.  A number of factors play a big role in survival of all esophageal cancer diagnoses, from Stage I to Stage IV.   These factors include but are not limited to treatment and the overall health of the patient.

The purpose of this post is to stress the importance of:

1. Early detection of esophageal cancer and

2. Research of treatment options aimed at curing advanced esophageal cancer.

“When esophageal cancer is found very early, there is a better chance of recovery. Esophageal cancer is often in an advanced stage when it is diagnosed. At later stages, esophageal cancer can be treated but rarely can be cured.” (National Cancer Institute)

“When esophageal cancer is found very early, there is a better chance of recovery.”

When patients are diagnosed with early stage esophageal cancer, the 5-year survival rate is 39.6%.

Unfortunately, only 21.3% of patients are diagnosed with esophageal cancer at the local stage.  The term “local stage” means that the cancer is only growing in the esophagus.

If and when standard and routine guidelines are established for screening of esophageal cancer, it will help to increase the number of people who are diagnosed early and therefore improve the chances of survival.

 “Esophageal cancer is often in an advanced stage when it is diagnosed.”

More than 67% of patients are diagnosed with regional or distant esophageal cancer.  The 5-year survival rate of regional esophageal cancer is 21.1%.   However, distant esophageal cancer, which is also referred to as Stage IV esophageal cancer, has a 5-year survival rate of less than 4%.

“At later stages, esophageal cancer can be treated but rarely can be cured.”

When esophageal cancer is diagnosed in late stages, it is difficult to completely rid the patient of cancer. Treatment options rarely include surgery.   The main focus of treatment for advanced esophageal cancer is to control the cancer and to relieve any symptoms caused by the cancer.  The latter is called palliative therapy.  (American Cancer Society)

The Salgi Esophageal Cancer Research Foundation strives to provide people with information they need to be proactive about their potential risk and to seek the help of a doctor.   We must work together to change the course of this deadly cancer.

For more information, please visit the sources below that were used in this post.  Please remember to connect with us on Facebook to share this life-saving information.

 
-Esophageal Cancer Treatment (PDQ®), National Cancer Institute, cancer.gov
-SEER Stat Fact Sheets: Esophageal Cancer, Surveillance, Epidemiology and End Results Program, seer.cancer.gov
-Survival rates for cancer of the esophagus by stage; Treating cancer of the esophagus by stage;Palliative therapy for cancer of the esophagus, American Cancer Society, cancer.org

Glen Larson, creator of ‘Knight Rider,’ ‘Battlestar’ and ‘Magnum PI’ died of esophageal cancer.

November 17, 2014
 A portion of this post appears on The New York Times, Glen A. Larson, Producer of ‘Knight Rider’ and ‘Magnum, P.I.,’ Is Dead at 77

GERD Awareness Week: November 23-29th

November 13, 2014

Thanksgiving, a time for family and friends to gather together, share thanks and enjoy a delicious feast. But did you know that the week of Thanksgiving is also dedicated to bringing awareness to a disease that affects one out of five Americans?

That disease is Gastroesophageal Reflux Disease (GERD).  Also known as acid reflux disease, GERD is a condition of the digestive system which has increased significantly in recent decades.

GERD is also a primary risk factor for esophageal cancer, the fastest growing cancer in the United States.  Esophageal cancer, similar to GERD, has also increased significantly in past decades.  In fact, incidence of esophageal cancer has risen over 600% and with an overall five-year survival rate of 17.5%, is among the deadliest of cancers.

Click here to learn how you can help spread awareness of GERD Awareness Week!

 

RefluxMD, a SaRefluxMDn Diego, CA, based Internet healthcare company focused on helping people suffering from GERD, has teamed up with The Salgi Esophageal Cancer Research Foundation, a nonprofit charity located in Rhode Island, to bring awareness of the dangerous link between GERD and esophageal cancer.

GERD occurs when the lower esophageal sphincter (LES) is weakened or damaged.  “The function of the LES is to act as a gatekeeper, opening to allow food to pass into the stomach and then closing to prevent the contents of the stomach (food, acid and other secretions) from back flowing or refluxing into the esophagus,” Bruce Kaechele, founder of RefluxMD states.

Heartburn, a common symptom of GERD, does not typically cause major concern, as billions of Americans experience it at some point in their lives.   However, persistent heartburn which occurs two or more times a week should not be taken lightly.

gerd_les_ esophageal cancer

Some lifestyle changes can help to manage GERD symptoms, including avoid eating at least three hours before bed, stay upright after meals, lose weight, moderate exercise and avoiding certain foods that trigger symptoms.  Surgery may be an option for some patients.  Kaechele warns that “GERD is a progressive disease and can worsen if not treated properly.”

Overtime, the backflow of acid damages the lining of the esophagus and can cause serious medical conditions, which include chronic cough or hoarseness, bleeding or scarring of the esophagus, ulcers or Barrett’s esophagus (which is an abnormal change in the lining of the esophagus that increases the risk of esophageal cancer).

President of The Salgi Foundation, Linda Molfesi, knows all too well the dangers of acid reflux.  “My father suffered from chronic acid reflux for years and was never warned by doctors of any possible risks.  We never knew how much damage his reflux was causing until it was too late.” Molfesi continued, “My father passed away a little over a year from the time he was diagnosed with esophageal cancer.  It was and still is devastating.”

Many chronic heartburn sufferers turn to antacids or other over-the-counter medications for relief.  Others seek help from their doctors and are prescribed medications known as Proton Pump Inhibitors (PPIs), which reduce the amount of acid in the stomach; treating the symptoms of GERD but not the disease.  Many PPI medications no longer require a prescription and can be purchased over-the-counter.

A recent poll conducted by RefluxMD concerning PPI medications showed that the majority of patients who were prescribed PPIs by their doctors were never told that the medications “only treated symptoms, but that reflux would continue and the disease could progress,” and were also never told that “there were potential negative side effects (e.g. osteoporosis, bacterial infections, etc.”)

According to RefluxMD, PPIs are overprescribed.  “Research has proven that over 30% of daily PPI users are not refluxing.  Although long-term use of PPIs daily may reduce or eliminate symptoms; they do not stop the flow of stomach contents into the esophagus.  Consequently, GERD can progress and potentially lead to serious complications, such as Barrett’s esophagus or esophageal cancer.”

It is important to never stop taking any medications until you have spoken to your doctor.

In addition to GERD, other risk factors associated with esophageal cancer include obesity, poor nutrition, tobacco use, excessive drinking and Barrett’s esophagus.  Unfortunately esophageal cancer has few, if any, early symptoms.  Symptoms such as difficulty swallowing, chronic cough or hoarseness, food getting stuck or choking while eating often occurs once the cancer has spread and reaches an advanced stage.

Since there are currently no routine or standard screenings to detect esophageal cancer in its earliest stages, Molfesi encourages those who may be at risk to be proactive and get screened as early as possible to see if there is any damage.

RefluxMD and The Salgi Foundation urge people to “Never ignore frequent heartburn and never rely on medications alone. Talk to your doctor about all of your options, especially how you can get screened for any possible damage.”

Click here to learn how you can help spread awareness of the dangerous link between chronic heartburn and acid reflux.

 


The Salgi Esophageal Cancer Research Foundation:
A 501(c)(3) nonprofit charity established in Rhode Island. The Salgi Foundation’s mission is to raise awareness, encourage early detection and to fund research of esophageal cancer in hopes of a cure.

RefluxMD: A San Diego-based RefluxMD believes there is a better way to treat reflux disease. The Internet healthcare company has partnered with leading reflux specialists to champion a new approach to more effectively treat reflux disease patients and to create tools that help patients take control of their treatment. RefluxMD is designed to be a complete, personalized reflux resource. Visit: www.refluxmd.com


Proton Pump Inhibitors (PPIs) do not reduce the risk of esophageal cancer

November 12, 2014

For years, doctors and researchers believed that Proton Pump Inhibitors (PPIs) can reduce the risk of esophageal cancer.   Over the past decades, esophageal cancer has increased over 600% and is now the fastest growing cancer in the United States*. Esophageal cancer is also one of the deadliest cancers, as less than 20% of those diagnosed with esophageal cancer will only survive five years.

While there are no known reasons for this alarming rise in esophageal cancer, researchers agree that the increase in obesity and Gastroesophageal Reflux Disease (GERD) may be to blame.*

But new research shows that PPIs may also play a significant role in the increase of esophageal cancer.

What are Proton Pump Inhibitors (PPIs)?

Proton pump inhibitors (PPIs) are medicines that work by reducing the amount of stomach acid made by glands in the lining of your stomach. PPIs are used to treat the symptoms of Gastroesophageal Reflux Disease.*

Gastroesophageal Reflux Disease (GERD) is a primary risk factor for esophageal cancer.

Gastroesophageal Reflux Disease (GERD) is a condition in which the stomach contents (food or liquid) leak backwards from the stomach into the esophagus (the tube from the mouth to the stomach). This action can irritate the esophagus, causing heartburn and other symptoms.

gerd_les_ esophageal cancer

What causes GERD?

GERD occurs when the lower esophageal sphincter (LES) is weakened or damaged. The LES is then unable to close and keep food, acid and other secretions from flowing backwards or refluxing into the esophagus. Overtime, the reflux of stomach contents and acids can cause serious damage to the esophagus, including bleeding and scarring of the esophagus, ulcers, Barrett’s esophagus and esophageal cancer.

Lifestyle changes can help to manage GERD symptoms.

Some of these changes are to avoid eating at least three hours before bed, stay upright after meals, lose weight, moderate exercise and avoiding certain foods that trigger symptoms. Surgery may be an option for some patients.

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PPIs only treat the symptoms of acid reflux disease.

Many chronic heartburn sufferers turn to antacids or other over-the-counter medications for relief. Others seek help from their doctors and are prescribed medications known as Proton Pump Inhibitors (PPIs), which reduce the amount of acid in the stomach; treating the symptoms of GERD but not the disease. Some PPIs do not require a prescription and can be also purchased over-the-counter.

RefluxMD states:  “since their introduction in 1989 the cost of [PPIs] has grown to over $11 billion dollars annually while adenocarcinoma, esophageal cancer that results from GERD, has become the fastest growing cancer in the US, Europe, Japan and Australia (Reflux-Induced Esophageal Cancer Trends)

PPIs work to control the symptoms of GERD but they do not reduce acid reflux or prevent the progression of the disease and the damage to the esophagus, RefluxMD 

Dr. Jaime Koufman, a physician in New York who specializes in voice disorders and acid reflux, wrote an article in the New York Times which details the dangerous link between acid reflux, PPI use and esophageal cancer.

“A Danish study published this year concluded that there were no cancer-protective effects from using the common anti-reflux medications, called proton pump inhibitors and that regular long-term use was actually associated with an increased risk of developing esophageal cancer.”

The Danish study also showed that “PPI use may facilitate the formation of carcinogenic bile acids.”  These bile acids are responsible for the sometimes pre-cancerous condition known as Barrett’s esophagus and an elevated risk of esophageal cancer.

Stomach juices also contain the compound gastrin, which has been shown to “stimulate cell growth that may contribute to cancer.” The Danish study showed that levels of gastrin can increase with the use of PPIs and other similar medications and that PPIs “may increase the risk of gastrointestinal tumours.” (People’s Pharmacy)

Danish researchers agree that further research is needed to study the association of PPIs, acid reflux and esophageal cancer. However, they offer the following suggestion for PPI use:

“Until the results from future studies can further elucidate the association, PPIs should be restricted to symptom control according to current guidelines. Hence, PPIs may not protect against malignant progression in BO [Barrett's Oesophagus] patients and in selected high-risk patients, clinicians may consider adding or replacing long-term medical treatment with other modalities.”*

Do not stop taking any medications and do not make any changes regarding your health without first consulting your doctor. It is important to discuss these issues with your doctor and explore alternate ways to reduce and/or treat your acid reflux disease and to reduce your risk of esophageal cancer.

Methods of preventing esophageal cancer need to be researched and that can only happen with your help! Consider a financial contribution to help support research, which will explore prevention of esophageal cancer research. Click here to donate.

 
 
 
 
Sources:
WebMD
National Center for Biotechnology Information
MedlinePlus
National Library of Medicine
RefluxMD
New York Times
MedScape
People’s Pharmacy
 

The Dangers of Eating Late at Night

November 7, 2014

Dr. Jamie A. Koufman, a physician in New York who specializes in voice disorders and acid reflux, explains how a poor diet and eating late at night can tremendously impact your health and even raise the risk of esophageal cancer.  Dr. Koufman also details ways to help combat acid reflux without taking a pill.

 

The Dangers of Eating Late at Night

ACID REFLUX is an epidemic affecting as many as 40 percent of Americans. In addition to heartburn and indigestion, reflux symptoms may include postnasal drip, hoarseness, difficulty swallowing, chronic throat clearing, coughing and asthma. Taken together, sales of prescribed and over-the-counter anti-reflux medications exceed $13 billion per year.

The number of people with acid reflux has grown significantly in recent decades. Reflux can lead to esophageal cancer, which has increased by about 500 percent since the 1970s. And anti-reflux medication alone does not appear to control reflux disease. A Danish study published this year concluded that there were no cancer-protective effects from using the common anti-reflux medications, called proton pump inhibitors, and that regular long-term use was actually associated with an increased risk of developing esophageal cancer.

What is responsible for these disturbing developments? The answer is our poor diet, with its huge increases in the consumption of sugar, soft drinks, fat and processed foods. But there is another important variable that has been underappreciated and overlooked: our dinnertime.

I specialize in the diagnosis and management of acid reflux, especially airway reflux, which affects the throat, sinuses and lungs. Airway reflux is often “silent,” occurring without telltale digestive symptoms, like heartburn and indigestion. Most of the tens of thousands of reflux patients that I have seen over the last 35 years are well today because I treat reflux by modifying my patients’ diets and lifestyles.

Over the past two decades, I’ve noticed that the time of the evening meal has been trending later and later among my patients. The after-work meal — already later because of longer work hours — is often further delayed by activities such as shopping and exercise.

Typical was the restaurateur who came to see me with symptoms of postnasal drip, sinus disease, hoarseness, heartburn and a chronic cough. He reported that he always left his restaurant at 11 p.m., and after arriving home would eat dinner and then go to bed. There was no medical treatment for this patient, no pills or even surgery to fix his condition. The drugs we are using to treat reflux don’t always work, and even when they do, they can have dangerous side effects. My patient’s reflux was a lifestyle problem. I told him he had to eat dinner before 7 p.m., and not eat at all after work. Within six weeks, his reflux was gone.

In my experience, the single most important intervention is to eliminate late eating, which in the United States is often combined with portions of large, over-processed, fatty food. Europeans have fewer cases of reflux than we do, even though many of them eat late. That’s most likely from portion control. In France, for example, a serving of ice cream is typically a single modest scoop, while in America, it’s often three gargantuan scoops.

For my patients, eating late is often accompanied by overeating, because many skip breakfast and eat only a sandwich at lunch. Thus the evening meal becomes the largest meal of the day. After that heavy meal, it’s off to the sofa to watch television. After eating, it’s important to stay upright because gravity helps keep the contents in the stomach. Reflux is the result of acid spilling out of the stomach, and lying down with a full stomach makes reflux much more likely.

And if you add an after-dinner dessert or bedtime snack? Again, reflux is a natural consequence. In a healthy young person, the stomach normally takes a few hours to empty after a moderate-size meal. In older people or those who have reflux, gastric emptying is often delayed. Further, those dessert calories tend to be high in carbohydrates and fat, and high-fat foods often create reflux by slowing digestion and relaxing the stomach valve that normally prevents reflux. Other popular but notoriously bad-for-nighttime-reflux foods and beverages are mints, chocolate, soft drinks and alcohol.

Many of my patients find that eating earlier alleviates their allergies,sinusitis, asthma, sleep apnea and diabetes symptoms. Although these conditions may not seem linked, postnasal drip and a cough are typical reflux symptoms that can easily be mistaken for something else.

Some of my patients who arrive complaining of reflux already eat healthfully. For them, dining too late is often the sole cause of their problem. And yet, hearing that they need to change the timing of their meals is sometimes a challenge they cannot meet.

A New Yorker with reflux came to see me because both her father and uncle died of esophageal cancer and she was afraid of getting it, too. This patient was a prominent businesswoman and her nightly routine included a 9 p.m. dinner at an elegant restaurant with at least two bottles of good red wine for the table. Her reflux was serious, and I explained that changes were needed.

She listened, then left and did not come back to see me for a year. When I saw her again, she explained what had happened. “For the first two months I just hated you,” she told me, “and then for the next two months — I was having some trouble swallowing — I figured I was going to die of esophageal cancer.” Then she nudged me and added, “You know, we’re the reason that it’s not so easy to get 6 p.m. reservations at the good restaurants anymore.”

To stop the remarkable increase in reflux disease, we have to stop eating by 8 p.m., or whatever time falls at least three hours before bed. For many people, eating dinner early represents a significant lifestyle shift. It will require eating well-planned breakfasts, lunches and snacks, with healthy food and beverage choices.

—Copyright 2014 New York Times 

 

 

Dr. Jamie A. Koufman    Photo: Voice Institute of NY

 

Dr. Koufman is the Founder and Director of the Voice Institute of New York and co- author of the  New York Times best selling book: Dropping Acid: The Reflux Diet Cookbook & Cure.  

Follow Dr.  Koufman on Twitter (@RefluxDoctor) and connect with her on Facebook. 

 

 

 

 

 

 

Source: Koufman, Jaime A. “The Dangers of Eating Late at Night.” The New York Times, October 26, 2014, Accessed: November 7, 2014.  Access the original article: nytimes.com

 


Clinical Practice Guidelines Address Multimodality Treatment for Esophageal Cancer

November 6, 2014

The Society of Thoracic Surgeons (STS) has released new clinical practice guidelines for treating cancer of the esophagus and gastroesophageal junction (area where the esophagus meets the stomach).

Multimodality Treatment: Therapy that combines more than one method of treatment. (NCI)

The guidelines, published in the November 2014 issue of The Annals of Thoracic Surgery, include nine evidence-based recommendations that address issues related to multimodality care, including neoadjuvant therapy (chemotherapy and radiation therapy given prior to surgery).

The goal of neoadjuvant therapy is to reduce the extent of cancer before an operation to maximize the chance of obtaining a cure.

“Despite the widespread enthusiasm for multimodality therapy and the myriad of its aspects, currently available data for each component of care are not truly definitive,” said Guideline Task Force Chair Alex G. Little, MD, from the University of Arizona in Tucson.

“The recommendations included in our document are guidelines, not mandates, but we feel they identify best current practices.”

The Society of Thoracic Surgeons

STS Clinical Practice Guidelines are intended to assist physicians and other health care providers in clinical decision making by describing a range of generally acceptable approaches for the diagnosis, management, or prevention of specific diseases or conditions.

Prior to publication, each guideline undergoes an intense peer-review process, which provides critical, unbiased scientific assessment of the document and helps to identify future areas of investigation.

The Society has 18 current clinical practice guideline documents, including one released in July 2013 on factors affecting the diagnosis and treatment of localized esophageal cancer. Future guidelines on esophageal cancer will address esophageal resection and early stage disease.

“Understanding that technology continues to advance and even biological behavior can be modified, patient care decisions should be made by a multispecialty group with input from all relevant specialists,” said Dr. Little.

Founded in 1964, The Society of Thoracic Surgeons is a not-for-profit organization representing more than 6,900 cardiothoracic surgeons, researchers, and allied health care professionals worldwide who are dedicated to ensuring the best possible outcomes for surgeries of the heart, lung, and esophagus, as well as other surgical procedures within the chest. The Society’s mission is to enhance the ability of cardiothoracic surgeons to provide the highest quality patient care through education, research, and advocacy.

To obtain a full copy of the Guidelines, click here.

 


 

Source: The Society of Thoracic Surgeons


Trial results reveal first targeted treatment to boost survival for esophageal cancer

November 5, 2014

Patients with a specific type of esophageal cancer survived longer when they were given the latest lung cancer drug, according to trial results being presented at the National Cancer Research Institute (NCRI) Cancer Conference.

Up to one in six patients with esophageal cancer were found to have EGFR duplication in their tumour cells and taking the drug gefitinib, which targets this fault, boosted their survival by up to six months, and sometimes beyond.

This is the first treatment for advanced esophageal cancer shown to improve survival in patients whose initial course of chemotherapy treatment has failed.

Donate to help fund life-saving esophageal cancer research here!

It is also the first time a targeted treatment of any kind has proved effective in this disease, although chemotherapy and some targeted drugs have shown benefit in the second line treatment of other cancers of the digestive system including stomach cancer.

The trial – called ‘TRANS-COG’ – looked for extra copies of a gene called EGFR in tumour samples from 295 deceased esophageal cancer patients who had received either gefitinib or placebo as part of the COG trial.

Of the 48 patients who had extra EGFR copies in their tumour cells, 13 per cent of those who had gefitinib survived for at least a year, while none of the patients who received a placebo survived that long.

Giving gefitinib to patients who didn’t have extra EGFR copies made no difference to how long they survived. This suggests that EGFR testing could identify a subgroup of esophageal patients who may benefit from gefitinib.

Dr Russell Petty, a medical oncologist from the University of Aberdeen, who is presenting the data, said: “This is exciting news in our field. It’s the first time any drug has shown survival benefit for esophageal patients who have stopped responding to their initial treatment. To date there’s been disappointingly little progress in treating this cancer type, which kills nearly 8,000 people a year and sadly is often diagnosed late making it difficult to treat successfully.

Esophageal cancer is the fastest growing cancer in the Untied States and other western countries.

In fact, esophageal cancer has increased over 600% in the US in past decades.  An often lethal diagnosis, esophageal cancer does not usually show any symptoms (such as difficulty swallowing) in early stages.  Symptoms, such as difficulty swallowing, often appear once the cancer has spread and becomes advanced.

When esophageal cancer is diagnosed in late stages, it is very difficult to treat the cancer and there is rarely a cure.  Patients who are diagnosed with Stage IV esophageal cancer face a five-year survival rate of only 3.8%.

“It’s thought that up to 16 per cent of esophageal cancer patients could benefit from gefitinib, providing valuable extra months of life to people who would otherwise have had very few options available to them.”

Irene Black’s late husband, Roy, was diagnosed with esophageal cancer in January 2011 aged 78, after having problems swallowing and later being rushed into A&E for an emergency endoscopy. He was given an intense course of chemotherapy and radiotherapy at Aberdeen Royal Infirmary, but unfortunately the cancer stopped responding and the family were told it was incurable. It was then that Roy decided to join the trial.

Irene Black’s late husband, Roy, took part in the COG and TRANS-COG trials (photo via: cancerresearchuk.org)

Irene said: “There is no doubt in my mind that, if it wasn’t for the trial, Roy wouldn’t have been with us for so long. He managed to get back to his bingo, which he loved, surrounded by friends and we booked a four night holiday on the west coast at Fort William. I will always treasure that holiday – if it wasn’t for the trial we may not have had the special time together at the end.”

“It’s comforting to know that the trial Roy took part in when he was alive may help patients with this devastating type of cancer live longer in the future.”

Professor Matt Seymour, NCRI’s clinical research director said: “Although the survival benefit for these patients was relatively modest, this trial is an important step forwards for a type of cancer where progress in treatment has fallen behind other cancers in recent decades. While there has been some success in treating other cancers of the digestive system, esophageal cancer remains extremely difficult to treat, with only 13 per cent of patients surviving five years or more. It will be interesting to see whether this drug, if properly targeted at the right patients, could offer similar benefits to those with earlier stage disease and also whether other drugs that target EGFR could prove to be even more effective.”

Esophageal cancer research is extremely underfunded, both from the government and other nonprofits.  You can make a difference by making a tax-deductible donation to help fund these research projects.  Click here to donate.

 

 

This post is adapted from a press release from CancerResearchUK.org

Other sources include: cancer.gov, cancer.org and cancer.net