By: Maayan S. Heller for Reflux1Until recently, a diagnosis of esophageal cancer meant an ominous prognosis. But new research gives hope to the tens of thousands of people facing this cancer, which has grown by a staggering 300 percent in the last 15 years.
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What you can do to help curb your risk factors:
Stop smoking! Nicotine relaxes the valve between the stomach and the esophagus, which can allow stomach acid and juices to back up (reflux) into the esophagus, which causes heartburn.
Change your eating habits and lose weight if necessary.
Avoid danger foods – examples of foods that can aggravate the symptoms of GERD and cause heartburn are: Citrus fruits, fatty foods, fried foods, onions, mint, spicy food, pizza or spaghetti sauce (or other tomato-based foods), chocolate, garlic – you don’t need to eliminate them from your diet altogether, just avoid them when you can.
Make lifestyle changes fun – include friends, family or spouses in diet and exercise programs and play with recipes that incorporate such dietary helpers like whole grains, whole wheat, beans and other high-fiber products.
Reduce pressure on your stomach – pressure on your stomach can push stomach juices into your esophagus and cause heartburn. Avoid this by not eating to fullness, avoiding lying down for three hours after meals, avoiding tight clothes on your stomach, and taking care when lifting and bending.
Reduce your risk by getting treatment for GERD: Click here to learn more about pharmaceutical and surgical treatments for GERD.
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Esophageal cancer, while still diagnosed at a rate 10 times lower than breast cancer, is currently the fastest-growing cancer in the United States. According to experts, this is largely because of the pervasiveness of chronic heartburn disease, or GERD.Two decades ago, nearly all patients diagnosed with esophageal cancer had the squamous form of this malignancy, caused by smoking and drinking. Now, however, the majority of esophageal cancers are glandular carcinomas, which are caused exclusively by the reflux disease known as GERD (gastroesophageal reflux disease).
In fact, “20 years ago the GERD-related kind were fairly nonexistent,” says Jeffrey H. Peters, M.D., FACS, a professor and chairman of the department of surgery at the University of Rochester in New York and co-author of a new study on esophageal cancer.
“The cancer has changed and the reasons for it have changed,” says Peters, who contends that the changes represent “one of the most dramatic changes known in all of human cancer.”
The study, published in the Journal of the American College of Surgery, found that with surgery, patients have a significantly greater chance for survival than they had in the past.
Before this research, the chance surviving esophageal cancer was thought to be quite low, at about 20 to 25 percent. But the study’s findings show a different picture.
“The study showed that in good hands, it can be up to 50 percent, which is an enormous change,” says Peters. “We’re talking about doubling survival.”
Of 263 patients treated surgically for their cancers, almost half of the study participants survived for five years or more. Additionally, the outcome was found to be even better for those patients who had lymph nodes removed along with the cancer.
“Any one study doesn’t define facts, but I think it’s quite conclusive,” says Peters.
For years, the attitude has been that treatment for esophageal cancer may not outweigh the risks since the chances of long-term survival were low, but these numbers show a significant difference.
“We want to show that the prognosis is not as dismal,” says Peters. “For patients facing the choice of having surgery or not – the whole mindset needs to change, because the prognosis is much better now than people realize.”
Dr. Peters explains that this change is occurring due to a combination of increased awareness and improved technology and treatment techniques, and he identifies three main factors that have improved the outlook for patients.
For one, the public is more educated about the disease and its causes.
“Patients are coming to us earlier, so we’re seeing smaller tumors,” he says.
Secondly, the surgery is getting better. Peters says that while these types of cancers have been treated with surgery for years, the technology, specifically the use of endoscopes, has enhanced the procedure and made it more precise.
The third factor is chemotherapy and radiation.
Most cancers of the GI tract are primarily treated surgically, and research hasn’t conclusively determined whether chemotherapy and radiation help. But Peters and his colleagues believe that surgery combined with chemo and radiation treatment can enhance the prognosis.
Dr. Peters is excited about the possibilities that this research identifies, but says there is more to be done.
“We need to understand better who’s getting these [cancers] and how to predict them and we need research on why GERD causes it,” he says, adding that checking out possible testing options, like using endoscopies for screening, is on the radar.
So, it seems, there is hope.
