Wednesday, December 15, 2010

Treating Esophageal Cancer

Need another reason to stop smoking or to lose weight? Consider the mortality rate of esophageal cancer. Each year there are around 16,000 people diagnosed and 14,500 people die, putting it alongside lung, pancreatic and ovarian cancer as one of the most deadly cancers. Famous people with esophageal cancer include actors Humphrey Bogart, Ron Silver and author Christopher Hitchens.

The risk factors for squamous cell esophageal cancer are tobacco abuse, alcohol abuse and injury, which can include drinking very hot liquids on a regular basis. The risk factors for adenocarcinoma include gastroesophageal reflux (GERD) and obesity.

Last week, thoracic surgeon Nikhilesh M. Korgaonkar, MD, MBA, discussed updates in surgery and esophageal cancer at Sinai Hospital Grand Rounds.

“Surgery is achieving its goal, but better systemic treatments are needed to increase the benefits of optimal local control,” he said. While there are many surgical approaches, one with a high rate of satisfaction is a transhiatal esophagectomy. In this procedure, a surgeon removes part of the esophagus and moves up the stomach into the chest, then connects the remaining esophagus to the stomach through the neck. In one study of patients following a transhiatal esophagectomy, 89 percent said they were pleased with the ability to eat and 96 percent said that in hindsight they would choose to have the same operation again.

In addition to surgery, many studies showed that the most positive results were found in patients who had chemotherapy and radiation therapy concurrently. Additionally, patients with chronic GERD symptoms should be monitored for Barrett’s esophagus, Korganokar says. Up to 50 percent of patients who are undergoing an esophagectomy for Barrett’s esophagus with high grade dysplasia end up having adenocarcinoma.

To learn more about Dr. Korganokar or cancer treatment at LifeBridge Health, call 410-601-WELL (9355).

-Elizabeth Leis-Newman

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