Can Statin Use After Diagnosis of Esophageal Cancer Prolong Survival? (AGA Journals)

March 29, 2016

via: journalsblog.gastro.org

“Statin use after a diagnosis of esophageal adenocarcinoma, but not esophageal squamous cell carcinoma, reduces esophageal cancer–specific and all-cause mortality, researchers report in the April issue of Gastroenterology.

Esophageal cancer is the fifth most common cause of cancer-related death in men and eighth most common cause in women, worldwide. Esophageal squamous cell carcinomas (ESCC) are the most common histologic subtype worldwide, but the incidence of esophageal adenocarcinoma (EAC) has increased rapidly since the 1970s and the most common form in the West. Fewer than 20% of patients with esophageal cancer survive for 5 years.

Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) are cholesterol-lowering drugs that have also been reported to have anti-cancer effects. Statin use after diagnosis has been associated with a reduced risk of cancer-specific mortality in from prostate, breast, and colorectal carcinomas. Statins were also found to reduce risk of liver cancer.

Statin use has been inversely associated with the development of the histologic subtypes of esophageal cancers. However, it is not clear whether statin use after a diagnosis of esophageal cancer prolongs survival, or has different effects on EAC vs ESCC.

Leo Alexandre et al sought to determine whether statin use after a diagnosis of esophageal cancer reduced cancer-specific and all-cause mortality in a large cohort (4445 men and women) in the United Kingdom. They collected their data from the United Kingdom General Practice Research database, the UK National Cancer Registry, and the Office of National Statistics database.”

To read more about the findings, visit: journalsblog.gastro.org

 


University of Louisville researchers find association between oral bacteria and esophageal cancer (ECSS)

March 3, 2016

Via: Kyforward.com

Louisville, KY– “University of Louisville School of Dentistry researchers have found a bacterial species responsible for gum disease, Porphyromonas gingivalis, is present in 61 percent of patients with esophageal squamous cell carcinoma (ESCC).

The findings, published recently in Infectious Agents and Cancer, only detected P. gingivalis in 12 percent of tissues adjacent to the cancerous cells, while this organism was undetected in normal esophageal tissue.

“These findings provide the first direct evidence that P. gingivalis infection could be a novel risk factor for ESCC, and may also serve as a prognostic biomarker for this type of cancer,” said Huizhi Wang, M.D., Ph.D., assistant professor of oral immunology and infectious diseases at the UofL School of Dentistry. “These data, if confirmed, indicate that eradication of a common oral pathogen may contribute to a reduction in the significant number of people suffering with ESCC.”

UofL School of Dentistry researchers Jan Potempa, David A. Scott, Richard J. Lamont and Huizhi Wang  (UofL Photo)

UofL School of Dentistry researchers Jan Potempa, David A. Scott, Richard J. Lamont and Huizhi Wang (UofL Photo)

The esophagus, a muscular tube critical to the movement of food from the mouth to the stomach, is lined with two main kinds of cells, thus there are two main types of esophageal cancer: adenocarcinoma and squamous cell carcinoma. The latter is more common in developing countries.

In collaboration with the College of Clinical Medicine of Henan University of Science and Technology in Luoyang, China, Wang and his UofL colleagues Richard J. Lamont, Ph.D., Jan Potempa, Ph.D., D.Sc., and David A. Scott, Ph.D., tested tissue samples from 100 patients with ESCC and 30 normal controls.”

To read more about the findings from the research team at UofL School of Dentistry, click here.


Barrett’s Esophagus Appears To Be Spiking in Younger Patients

July 17, 2015

GASTROENTEROLOGY & ENDOSCOPY NEWS

The incidence of Barrett’s esophagus (BE) among relatively young people has surged in recent years, an analysis of a large health care database has found.

The study, of 50 million unique patient records between 2008 and 2013, showed that while the absolute incidence remains low among people younger than age 55 years, the share of cases in that group climbed sharply over the five-year period. Meanwhile, cases of BE among people over age 55 fell, suggesting a demographic shift in the disease with potentially important implications for screening, according to the researchers. As a precancerous condition, BE may be more dangerous in younger patients because of the longer time for the abnormal cells to progress to malignancy.

“The increase in the rate of BE was particularly high in the age group of 25 to 34 years,” said Sasan Sakiani, MD, of the Division of Gastroenterology at MetroHealth Medical Center, in Cleveland, and a study co-author.

Ronnie Fass, MD, director of the Division of Gastroenterology and Hepatology at MetroHealth, who helped conduct the study, said more research is needed to identify the underlying basis for the trend.

“The impetus behind the study was the growing number of younger patients with GERD [gastroesophageal reflux disease]-related symptoms who were diagnosed with Barrett’s esophagus in our clinic,” Dr. Fass said. “It was important for us to further assess this trend because of the important impact it will likely have on our current guidelines for BE screening.”

Dr. Sakiani’s group presented the findings at Digestive Disease Week 2015 (abstract SA1881). The researchers analyzed the Explorys database, which includes data from 317,000 providers admitting patients to 360 hospitals in the United States. The database was initially surveyed by the International Classification of Diseases, 9th edition code for GERD, symptoms of heartburn and other risk factors for BE. The researchers conducted additional analyses to find patients who underwent endoscopy and received a diagnosis of BE between 2008 and 2013, to establish an annual incidence by patient age, sex and race.

“There was a steady increase in both the number of endoscopic procedures performed each year and the incidence of BE,” Dr. Sakiani said. By 2013, the number of endoscopies had risen to 201,140 from 79,040 in 2008, while the incidence of BE increased from 1,970 to 4,269 over that period.

Read the full article, here.

 

Bosworth, Ted. “Barrett’s Esophagus Appears To Be Spiking in Younger Patients.Gastroenterology & Endoscopy News – Web. 17 July 2015.


“Let food be thy medicine and medicine be thy food”; Research explores Hippocrates’s adage

February 12, 2015

Are you eating at least five fruits and vegetables every day?

A new study published in the British Journal of Cancer suggests that some compounds found largely in fruits and vegetables called “flavonoids may reduce incidence and improve survival” for some cancers.

It is well-known that a diet rich in fruits and vegetables is beneficial to one’s health and well-being.  What is particularly exciting about this research is that it specifically focused on the two common types of esophageal cancer and gastric cancer.

The study is titled “Dietary intake of flavonoids and oesophageal and gastric cancer: incidence and survival in the United States of America (USA).”

Researchers interviewed patients that were diagnosed with esophageal cancer, both adenocarcinoma and squamous cell carcinoma and gastric cancer (adenocarcinoma).

Esophageal adenocarcinoma is the most common type of esophageal cancer in the western world and is the fastest growing cancer in the United States.*  

Also one of the deadliest cancers, esophageal cancer shows extremely poor survival rates, as the cancer is extremely aggressive and is typically caught in later, advanced stages. Currently, there are no routine or standard screenings to detect esophageal cancer in earlier stages.  The overall five-year survival rate is less than 18%.

According to the published abstract found on British Journal’s website, the researchers linked patients’ responses from food frequency questionnaires with USDA Flavonoid Databases and available literature for six flavonoid classes and lignans (chemical compound found in plants).

The abstract details that “flavonoids have experimentally demonstrated chemopreventive effects against esophageal and gastric cancers,” but there have been few studies which examine “flavonoid intake and incidence of these cancers and none have considered survival.”

Foods that may fight cancerWhile fruits and vegetables are the main sources of flavonoids, tea and red wine also contain the compound.

Certain fruits and vegetables can cause symptoms of Gastroesophageal Reflux Disease (GERD).  Therefore, acid reflux sufferers should be careful about consuming certain spicy, citrus and/or acidic food and drinks and should limit or completely avoid drinking wine.  It is important to speak to your doctor before making any changes to your health.

“Our findings, if confirmed, suggest that increased dietary anthocyanidin intake may reduce incidence and improve survival for these cancers,”  researchers stated.  To read the full abstract, please click here.

 

 


 

British Journal of Cancer, 10 February 2015; doi:10.1038/bjc.2015.25 bjcancer.com

“Esophageal Cancer On The Rise,” WebMD


Overweight children may be at higher risk of esophageal cancer as adults

February 10, 2015

Overweight children may be at higher risk of esophageal cancer when they grow up than their slimmer friends, according to research published this week in the British Journal of Cancer

Researchers* studied the health records of more than 255,000 Danish school children, born between 1930 and 1971, whose height and weight was measured every year between the ages of 7 and 13**. The researchers used this to go back and calculate their Body Mass Index (BMI).

BMI looks at weight compared to height and is a simple way of assessing whether people are a healthy weight.

More than 250 of the children went on to develop esophageal cancer over the age of 40. By matching these middle-aged patients with their school records, researchers found that children aged 9-13 with a higher BMI, who were more likely to be overweight or obese, appeared to be at greater risk of developing this type of cancer in later life.

Using their results from the 1930s to the 1970s, they calculated that 2.1 per cent of all oesophageal cases in adult men in Denmark could be attributed to boys being overweight or obese at the age of 13.

But they estimate that this figure could go up to around 17.5 per cent of all these male esophageal cancer cases in the future due to the rise in childhood obesity levels.

Dr Jennifer Baker, associate professor at The Institute of Preventive Medicine in Denmark and the University of Copenhagen, said: “Our results suggest that the increase in the number of overweight and obese children might lead to a significant rise in future cases of esophageal cancer.

“It may be that being overweight as a child is directly linked to a higher risk of developing this cancer in later life. Or it might be that overweight children are more likely to become overweight adults, and we know that being above a healthy weight as an adult is a risk factor for many cancers, including oesophageal.

More research is needed, but however the link works, our results underline how important it is for children to be a healthy weight – particularly as there is some evidence that overweight children could be at higher risk of other cancers later in life.”

Esophageal cancer – sometimes called cancer of the food pipe or gullet – is the 13th most common cancer in adults, with around 8,300 cases diagnosed each year in the UK.

In the United States, esophageal cancer is the fastest growing cancer with over a 600% increase in the past decades.

A previous Cancer Research UK study estimated that being overweight or obese causes more than one in four esophageal cancers in men and around one in 10 in women. This may be because people who are obese are more likely to suffer from acid reflux – when acid coming back up from the stomach can irritate the lining of the esophagus – which is a risk factor for esophageal cancer. A higher BMI is also associated with gastroesophageal reflux disease in children.

The Danish research did not take into account any social or lifestyle factors that might contribute to a person’s risk of developing cancer, but researchers say there was little evidence that these might have affected their results.

Dr Julie Sharp, head of health information at Cancer Research UK, said: “This research suggests that being overweight as a child could have effects on your health even decades later. It highlights how important it is to ensure that children eat healthily and are active, as this gives them the best possible start in life and could help to prevent them from developing diseases such as cancer in the future.”

Image via cancerresearchuk.org

 

This post is based on information provided by British Journal of Cancer.

Other sources: “Esophageal Cancer On The Rise,” WebMD


Transoral fundoplication is an effective treatment for patients with GERD

January 22, 2015

Transoral fundoplication is an effective treatment for patients with gastroesophageal reflux disease (GERD), especially for patients with persistent regurgitation despite proton pump inhibitor (PPI) therapy, according to a new study published in Gastroenterology, the official journal of the American Gastroenterological Association.

The most common symptom of GERD is heartburn.  Also known as acid reflux disease, GERD is one of the major risk factor associated with esophageal cancer, the fastest growing cancer in the United States.

“Despite therapy, patients with GERD often suffer from troublesome regurgitation, which impairs their quality of life,” said lead study author John G. Hunter, MD, from Oregon Health & Science University. “This study offers evidence that transoral fundoplication is effective in eliminating troublesome GERD symptoms, especially regurgitation, with a low failure rate and good safety profile for six months.”

Researchers performed a prospective, sham-controlled trial to determine if transoral fundoplication provided GERD patients with better relief of troublesome regurgitation, or the sensation of acid backing up into a patient’s throat or mouth, when compared to PPI therapy. The researchers randomly assigned 129 patients with troublesome regurgitation despite daily PPI use to transoral fundoplication using the EsophyX-2 device and six months of placebo, or a sham surgery and six months of once or twice daily omeprazole. Patients were then evaluated for six months.

The primary endpoint in this study, elimination of troublesome regurgitation, was achieved in a greater proportion of patients treated with transoral fundoplication than with omeprazole: 67 percent versus 45 percent. Further, a larger proportion of controls demonstrated no response at three months (36 percent) than patients who underwent transoral fundoplication (11 percent). Subjects from both groups who completed the protocol had similar reductions in GERD symptom scores. Severe complications were rare.

GERD remains one of the most common conditions for which Americans take daily medication, and PPI use has more than doubled in the last decade. Despite this, up to 40 percent of PPI-dependent GERD patients have troublesome symptoms of GERD.

Transoral fundoplication — an incisionless procedure that allows physicians to reshape the anti-reflux valve that prevents stomach acid and contents from flowing up into the esophagus — may offer a new treatment option for these patients.

This study provides evidence of transoral fundoplication’s efficacy, and will likely lead to more widespread use of the procedure in clinical practice.. To help health-care decision makers make informed decisions regarding this technology, the AGA Center for GI Innovation and Technology has partnered with EndoGastric Solutions® to establish the STAR Registry (Laparoscopic Nissen Fundoplication (LNF) Surgery Versus Transoral Incisionless Fundoplication (TIF®): Anti-Reflux Treatment Registry). The STAR Registry will provide the first real-world data observing patient outcomes following laparoscopic surgery and transoral fundoplication with the EsophyX® device. Learn more about this endeavor here.

Learn more about GERD in the AGA patient brochure.

 

 

This post is based on information provided by The American Gastroenterological Association.

Other sources: “Esophageal Cancer On The Rise,” WebMD


Father’s Cherished Gifts

January 16, 2015

This post was originally published on January 1, 2015 on the website: “On a Brighter Note” by Lori Welbourne.  Thank you Ms. Welbourne for allowing us to share this inspiring story.

FATHER’S CHERISHED GIFTS:

Two months ago my dad called and as soon as I heard the sound of his voice I knew something was wrong.

“Hi, Honey,” he said softly. “Do you have a couple of minutes?” Instinctively my eyes welled up with tears and I could feel my throat constrict.

“Yes,” I said, bracing myself for the news he was about to deliver. His voice uncharacteristically cracked with emotion as he told me he had esophageal cancer. Feeling the quick onset of a throbbing headache and a shortness of breath I failed to stop myself from crying out loud.

“I don’t want you to worry,” he said. “I’ll be going for tests and we’ll find out what can be done. I’ll keep you informed. Just think positive thoughts, okay? There’s nothing we can’t handle.”

After our conversation ended and I hung up the phone I no longer tried to control my sorrow and allowed myself to weep with abandon.

Ken White was only 67 years old and had just retired in May. He was full of life and excited about the future. He’d been diagnosed with skin cancer and a slow-growing leukemia not long ago – both of which he’d downplayed as nothing to be concerned about. But this new discovery of a life-threatening tumor in his lower esophagus was alarming.

I spent the rest of the afternoon and evening in a haze. I tried to only think optimistically as he requested, but I found myself emotionally raw and physically drained, breaking down in tears several times over the next few days. After our mother’s death less than a year prior I’d convinced myself that our healthy father would live to be at least 100 years old.

Over the next couple of weeks, as he went for tests and we waited for results I got better at carrying out his wishes to only think positively, and when he called with an update I fully expected him to tell me the cancer was treatable. When my hopes were met I cried again, but this time with tears of joy.

“We’re going to fight this aggressively, Kiddo,” my dad said, detailing the weekly chemotherapy and daily radiation treatments for the entire month of December. “Hopefully the tumor will decrease in size and the surgeon will be able to remove it in the new year.”

As promised, Dad kept us updated with his progress, even sending smiling pictures of himself hooked up to an IV getting his chemo.

Since he was advised to avoid crowds and public places so his weakened immune system wouldn’t be challenged, we weren’t sure if we’d have the opportunity to see him at Christmas. Fortunately his doctors approved a visit from us providing we were in good health.

My children, husband, brothers, sister-in-law, nephews, uncle, grandma and I arrived at Dad’s place on Boxing Day at 11 am at his request. When we got to the door his wife said he was resting and summoned us into the living room. We visited quietly for awhile until we were suddenly interrupted by a jolly good bellowing of “Ho Ho Ho! Merry Christmas!”

Looking up in surprise, I watched my father enter the room wearing a Santa outfit and beard, ringing a bell and handing out gift cards to everyone.

Again I felt my eyes well up with tears of joy.

It was one of those moments I’ll never forget. Not because it caught us off guard in such a sweet and wonderful way, but because it so completely captured the essence of this man who always seems to react to everything with an optimistic frame of mind.

“My cup is never half empty,” he’s often said over the years. And from a lifetime of observing how he’s chosen to think, his cup isn’t just half full, it’s running over.

Dad’s jovial outlook has been an incredible blessing to our family. But the gift we cherish most is his unconditional love and support – something we adoringly give right back.


Would you like to share your personal experiences with esophageal cancer?  Learn more about how your story can make a difference: Share Your Story 

 

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