Proton therapy has fewer side effects in esophageal cancer patients, study finds.

May 26, 2015

New research by scientists at the University of Maryland School of Medicine has found that esophageal cancer patients treated with proton therapy experienced significantly less toxic side effects than patients treated with older radiation therapies.

Working with colleagues at the Mayo Clinic in Rochester, Minnesota and the MD Anderson Cancer Center in Dallas, Texas, Michael Chuong, MD, an assistant professor of radiation oncology at the school, compared two kinds of X-ray radiation with proton therapy, an innovative, precise approach that targets tumors while minimizing harm to surrounding tissues.

The researchers looked at nearly 600 patients and found that proton therapy resulted in a significantly lower number of side effects, including nausea, blood abnormalities and loss of appetite. The results were presented on May 22 at the annual conference of the Particle Therapy Cooperative Group, held in San Diego.

“This evidence underscores the precision of proton therapy, and how it can really make a difference in cancer patients’ lives,” said Dr. Chuong.

Patients with esophageal cancer can suffer a range of side effects, including nausea, fatigue, lack of appetite, blood abnormalities and lung and heart problems. Proton therapy did not make a difference in all of these side effects, but had significant effects on several.

The results have particular relevance for the University of Maryland School of Medicine; this fall the school will open the Maryland Proton Treatment Center (MPTC). The center will provide one of the newest and highly precise forms of radiation therapy available, pencil beam scanning (PBS), which targets tumors while significantly decreasing radiation doses to healthy tissue. This technique can precisely direct radiation to the most difficult-to-reach tumors.

esophageal cancer patients proton therapy new research study findings esophagus cancer patients

The National Association for Proton Therapy proton-therapy.org

 

Proton therapy is just one of several new methods for treating cancer. Others include:

  • Selective Internal Radiation Therapy, a precision modality for treating patients with particularly difficult-to-remove tumors involving the liver such as those from colorectal cancers;
  • Gammapod, a new, high-precision, noninvasive method of treating early-stage breast cancer;
  • Thermal Therapies, the use of “heat” in treating a broad spectrum of malignancies.

The treatment works well for many kinds of tumors, including those found in the brain, esophagus, lung, head and neck, prostate, liver, spinal cord and gastrointestinal system. It is also an important option for children with cancer and is expected to become an important option for some types of breast cancer. While most cancer patients are well served with today’s state-of-the-art radiation therapy technology, up to 30 percent are expected to have a greater benefit from the new form of targeted proton beam therapy.

This post is based on information provided by University of Maryland.

 


Cancer prevention guidelines may lower risk of obesity-linked cancers; including esophageal cancer.

January 6, 2015

Low alcohol consumption and a plant-based diet, both healthy habits aligning with current cancer prevention guidelines, are associated with reducing the risk of obesity-related cancers, a New York University study shows. The findings appear in the journal Cancer Causes & Control.

“Our research aims to clarify associations between diet and physical activity in relation to cancer to encourage at-risk individuals to make lifestyle modifications that may reduce their risk of certain cancers,” said Nour Makarem, a nutrition doctoral student at NYU Steinhardt and the study’s lead author.

A third of cancers are estimated to be related to excess body fat, and are therefore considered preventable through lifestyle changes. Obesity-related cancers include cancers of the gastrointestinal tract, reproductive organs, urinary tract, blood, bone, spleen, and thyroid.

Obesity is considered a risk factor for esophageal cancer, the fastest growing cancer in the United States, according to the National Cancer Institute.  Other risk factors for esophageal cancer include tobacco use, poor nutrition, excessive alcohol use and Gastroesophageal Reflux Disease (chronic acid reflux, heartburn being the most common symptom.)

In 1997, the World Cancer Research Fund and the American Institute for Cancer Research released cancer prevention guidelines advising on weight management, diet, and physical activity. These guidelines, updated in 2007, provide an integrated approach for establishing healthy habits that reduce cancer incidence.

In their study, Makarem and her colleagues sought to evaluate whether healthy behaviors aligning with the diet and physical activity cancer prevention guidelines are in fact associated with reduced risk for obesity-related cancers and the most common site-specific cancers (breast, prostate, and colorectal cancers).

The researchers analyzed medical and dietary data for 2,983 men and women who were part of the Framingham Heart Study, a 60-year population study tracking factors related to cardiovascular disease as well as cancer. Focusing on data from 1991 through 2008, they identified 480 obesity-related cancers among the participants.

In order to calculate the relationship between the cancer prevention recommendations and cancer incidence, the researchers created a seven-point score based on the recommendations for body fat, physical activity, foods that promote weight gain, plant foods, animal foods, alcohol consumption, and food preparation and processing.

After adjusting for other factors that could contribute to cancer risk, including age, smoking, and pre-existing conditions, the researchers found that the overall score, as a proxy for overall concordance to the guidelines, was not associated with obesity-related cancer risk. However, when score components were evaluated separately, two different measures emerged as strong predictors of cancer risk.

In the current study, adherence to alcohol recommendations – limiting alcoholic drinks to two for men and one for women a day – was protective against obesity-related cancers combined and against breast, prostate, and colorectal cancers. In addition, among participants who consume starchy vegetables, eating sufficient non-starchy plant foods (fruits, vegetables, and legumes) was associated with a lower risk of colorectal cancer.

“Based on the study’s results, dietary advice on preventing cancer should emphasize the importance of eating a plant-based diet and restricting alcohol consumption,” said Niyati Parekh, associate professor of nutrition and public health at NYU Steinhardt and the study’s senior author.

 

This post is based on information provided by New York University.

 


New Year Resolutions Could Lower Esophageal Cancer Risk

December 31, 2014

It is officially the New Year and for many, that also means setting New Year resolutions.   According to Reuters, “losing weight and getting fit and healthy are among the top five resolutions [made] every year.”

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Unfortunately, many of these goals fade away and are never fulfilled.   In  fact, forty-five percent of Americans make New Year resolutions each year, but only eight percent succeed, according to a University of Scranton study published in the Journal of Clinical Psychology.  While the odds are very much against the success of New Year resolutions, these goals are extremely important to our health, especially when it comes to esophageal cancer prevention.

Esophageal cancer is the fastest growing cancer in the United States, according to the National Cancer Institute.  It has increased over 600% in the past decades and shows no signs of slowing down.  As one of the deadliest cancers, esophageal cancer has an extremely poor 5-year survival rate of only 17.5%.

Some of the major risk factors associated with esophageal cancer are chronic heartburn (acid reflux), obesity, smoking and poor nutrition.

Losing weight, eating healthier, exercising and quitting tobacco use are all ways to help lower the risk of esophageal cancer, in addition to improving other aspects of overall health.

Below are five articles that we’ve chosen from throughout the web to help you create and, more importantly, stick to resolutions to improve your health.  Whether you create these goals today, tomorrow or well after the New Year, we support and encourage you to improve your health!

What is on your New Year resolution list?  Share them with us on Facebook!

 

 

Resources for New Year Resolution Success:

New Year’s resolutions- more procrastination than motivation, Reuters  

Tips for making GERD diet and lifestyle changes that stick, RefluxMD

The Key To Setting Achievable Goals, Huffington Post

11 Simple Health Habits Worth Adopting Into Your Life, Cleveland Clinic

Why your healthier lifestyle should start today, Medical Daily

 

 


Obesity, acid reflux precursors for esophageal cancer, experts say.

December 30, 2014

Driven by obesity and acid reflux, adenocarcinoma of the esophagus has become the fastest rising cancer in white men in the United States, said experts from Baylor College of Medicine and University of Pennsylvania Perelman School of Medicine in a review article published in New England Journal of Medicine. The review summarizes the latest developments in the risk factors, pathogenesis, diagnosis and treatment of the two major types of esophageal cancer.

“It’s important to remember that the risk factors (obesity and acid reflux) are potentially modifiable,” said Dr. Hashem El-Serag, senior author of the review and chief of gastroenterology and hepatology at Baylor.

Esophageal cancer is [considered] rare in young individuals but increases with age, peaking at ages 70 to 80. The cancer is three to four times as common in men as it is in women, the authors stated.

However, esophageal cancer is the fastest growing cancer in the US, according to the National Cancer Institute.  This also attributes to the increase in the number of men and women of all ages who have been diagnosed with cancer.

The review details how daily and weekly symptoms of acid reflux increase a person’s likelihood of developing this form of cancer. It also explains how abdominal obesity increases the risk of developing Barrett’s esophagus and cancer. Increased pressure causes the stomach to move upward, which can cause and exacerbate acid reflux symptoms.

Barrett’s esophagus, a precursor lesion to adenocarcinoma, can be detected through an endoscopy.

“People who are obese or have chronic acid reflux should consider having an endoscopy to be screened for Barrett’s or adenocarcinoma,” El-Serag stressed.

A technique called radiofrequency ablation can help prevent progression to cancer in those with Barrett’s esophagus who develop an abnormality called dysplasia.

“Radiofrequency ablation can be done endoscopically by a gastroenterologist,” El-Serag explained. “This reduces the risk of cancer and has proven safe and effective.”

He estimated that as many as 86 percent of dysplasia cases treated with radiofrequency do not go on to become cancer.

The other author in this review is Anil K. Rustgi, chief of gastroenterology at University of Pennsylvania Perelman School of Medicine, Philadelphia.

SOURCE:  Baylor College of Medicine


Study Shows Stretta Therapy for GERD Improves Sphincter of the GI Tract

December 26, 2014

A newly published, pathologist-blinded study in a porcine model, examines the histopathology changes after non-ablative radiofrequency (NARF) to smooth muscle as delivered by Stretta therapy for GERD and Secca therapy for fecal incontinence. Radiofrequency therapy is commonly thought of in terms of ablation, where tissue destruction occurs. In contrast, this study shows that this unique low power, low temperature non-ablative type of radiofrequency (NARF) improves the smooth-muscle sphincters of the GI tract, as well as the skeletal muscle of the external anal sphincter. The investigation confirms multiple mechanisms that may regenerate and improve the function of the treated sphincter muscles, offering symptom improvement for patients suffering from these debilitating disorders.

The study documented the following advantages of NARF in the presence of a compromised sphincter:

  • Hypertrophy of both smooth and skeletal muscle fibers
  • Smooth muscle size and muscle bundle increase
  • Interstitial Cells of Cajal (ICCs) decrease
  • Collagen I synthesis promotion, with an increase in the Collagen I/Collagen III ratio
  • Fibrosis is diminished, due to a regression of excessive collagen deposition
  • Similar effect on Type I and II fibers as reinervation (nerve regrowth)

Study senior author Dr. Steven Wexner, Director of the Digestive Disease Center and Chairman of the Department of Colorectal Surgery at Cleveland Clinic Florida, and a paid consultant for Mederi Therapeutics Inc., commented: “The results of this study should allow us to help patients with GERD and fecal incontinence, as the regeneration we see here clarifies the mechanism of action of radiofrequency treatment.”

Learn about a new animal study showing that non-ablative radiofrequency (NARF) treatments Stretta and Secca actually regenerate muscle in the GI tract and provide relief for symptoms of GERD and fecal incontinence.

Learn about a new animal study showing that non-ablative radiofrequency (NARF) treatments Stretta and Secca actually regenerate muscle in the GI tract and provide relief for symptoms of GERD and fecal incontinence.

The randomized study was performed on an animal model of fecal incontinence with three study arms: an experimental model of fecal incontinence with damage to the sphincter muscle, which remained untreated; a group with sphincter damage, treated with NARF; a control group without a damaged sphincter and without treatment. After 10 weeks the treated tissue was excised and preserved. The resulting H&E and trichrome slides were examined by two pathologists, who were blinded to the tissue sample origin.

Study principal author Dr. Mariana Berho, Director of the Pathology and Laboratory Medicine Center and of the Center for Research at Cleveland Clinic Florida and a paid consultant for Mederi Therapeutics Inc. explained:  “The results of this animal model study are extremely valuable as they may reflect the changes that take place in the human lower esophageal sphincter as well as the internal anal sphincter after the administration of radiofrequency.”

This investigation concluded that non-ablative radiofrequency application appeared to induce profound morphological changes in the sphincter muscle that lead to an anatomical state reminiscent of the baseline sphincter structure. Further, the regeneration of muscle explains how NARF therapies, Stretta and Secca work to improve the symptoms that accompany GERD and fecal incontinence.

For more information: www.stretta-therapy.com and www.secca-therapy.com.

SOURCE: Mederi Therapeutics Inc.


First two enrolees of AGA’s GERD Registry Have Successfully Undergone Treatment

December 26, 2014

The American Gastroenterological Association (AGA) Center for GI Innovation and Technology is pleased to announce that the first two enrollees in the STAR Registry — which seeks to compare laparoscopic surgery to an incisionless procedure to treat gastroesophageal reflux disease (GERD) — have successfully undergone treatment.

“This is an important milestone in AGA’s endeavor to develop national observational registries to help bring new medical devices and treatments to physicians and their patients in an efficient, safe and meaningful way,” said Ashish Atreja, MD, MPH, chair of the registry oversight subcommittee of the AGA Center for GI Innovation and Technology. “With each patient, we will collect valuable data evaluating safety, efficacy and comparative outcomes. The goal of this registry is to provide the entire health-care system — patients, payors, purchasers and providers — with evidence to back future technology decisions.”

As a neutral objective broker, 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. Transoral fundoplication is an incisionless procedure that allows physicians to reshape the anti-reflux valve that prevents stomach acid and contents from flowing up into the esophagus. Both of the surgical procedures for GERD examined in the STAR Registry are performed with FDA-cleared devices and techniques.

The first two patients, who underwent incisionless fundoplication, were treated at:

  • Lenox Hill Hospital in New York, NY, under the care of Anthony A. Starpoli, MD, and Gregory B. Haber, MD.
  • SurgOne Foregut Institute in Englewood, CO, under the care of Reginald Bell, MD.

“GERD is a deceptively complex condition and the most commonly used treatment options may not adequately serve all patients,” said Dr. Starpoli, associate director of esophageal endotherapy at Lenox Hill Hospital. “I’m honored to support the collection of data that will be used to evaluate the durability and safety of this technology, which could provide a new evidence-based treatment option for patients suffering from GERD.”

“By participating in this national observational registry, we are collecting important data that will improve the future of GERD treatment,” said Dr. Bell, founder of SurgOne Foregut Institute. “As a physician, I’m thrilled to know that I will have access to long-term efficacy data about patients who choose surgical therapy for GERD, which is invaluable to patient care decisions.”

As with all patients enrolled in the registry, data from the first two patients will be collected from standard follow up appointments with the patients, and the registry staff will also check in with the patients every six months for approximately three years following the GERD procedure. Researchers will use this data to compare effectiveness, safety, post-operative side effects or post-procedure costs associated with episodes of care and any ensuing complications.

 


 

Source: American Gastroenterological Association


Tips to Manage GERD During The Holidays!

December 23, 2014

The holidays are a wonderful time of year when family and friends can gather together and enjoy an abundant feast filled with our favorite foods.  Certain habits, however, can cause some unwanted holiday heartburn.

While occasional heartburn is not typically a cause for concern, as billions of Americans experience heartburn at some point in their lives, heartburn that occurs more than twice weekly should not be taken lightly, as it could be an indicator of GERD.    GERD stands for Gastroesophageal Reflux Disease which is a disease of the digestive system.

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Learn how to enjoy the holidays and all of the delicious foods while managing your acid reflux symptoms.  Here are a few tips for you to take with you to the holiday dinner table:

  1. Limit beverage consumption while eating.  Sometimes fluids, especially carbonated beverages, can cause more gas in the stomach when combined with food intake. Try to drink slowly after you are done eating.
  1. Monitor what you are eating and avoid foods that trigger acid reflux.  Foods that have the worse effects on acid reflux are spicy, fatty, fried and citrus foods. Food and drinks that trigger GERD symptoms vary from person to person, so it is important to know your body and determine which are best for you.
  1. Limit or avoid alcohol.  There are some people, however, who should avoid all alcohol consumption, as even the smallest amounts can cause acid reflux. Alcohol increases the production of stomach acids. Alcohol also relaxes the lower esophageal sphincter (LES), the muscle that is in charge of keeping stomach contents from refluxing into the esophagus.
  1. Don’t over-eat.  Ask for a smaller plate, take a small sample from each dish and choose “safe” foods that you’ve predetermined do not flare up your acid reflux symptoms. When you’re feeling tempted to overindulge, ask yourself “Is having that second helping of pumpkin pie worth the hours of pain and misery due to the acid reflux afterwards?”
  1. Chew slowly. Help your digestive system by chewing every bite slowly and thoroughly. Put your fork down in between bites to help remind yourself to go slow while eating.
  1. Wear loose clothing. Clothing which is tight especially around the mid-section can put extra pressure on the abdomen and increase acid reflux symptoms.
  1. Sit upright for several hours after you’ve eaten. Or better yet, take a leisurely family stroll around the neighborhood to help settle your stomach and aid digestion. Avoid any rigorous exercise, as it can upset the digestion process and cause reflux symptoms.
  1. Pass on the after-dinner coffee.  For some, coffee can increase acid reflux and cause symptoms to flare up.  Both caffeinated and decaffeinated coffee have shown to aggravate GERD symptoms.
  1. Ditch all tobacco products.  Tobacco, including cigarettes, cigars, chewing tobacco and pipe tobacco not only worsens GERD symptoms, but it can cause people to develop GERD.   Like alcohol, tobacco weakens the lower esophageal sphincter (LES) and increases stomach acids.

Also known as acid reflux disease, GERD is a progressive disease, which means that it worsens overtime, especially if it is not properly treated.  The reflux of acids from the stomach damages the lining of the esophagus and can cause major health problems, including an increased risk of esophageal cancer. Speak to your doctor if you are experiencing frequent or chronic heartburn or if your acid reflux symptoms are worsening.

If you, or someone you know, has GERD, RefluxMD has put together an eBook that is surely a must-read!  To download a FREE copy of “I Have GERD, Now What?”, click here.