Trans-Nasal Esophagoscopy (TNE) is the better option, and it works like this: a doctor numbs the nose, inserts a thin, flexible tube — no bigger than a pencil — through the nostril and into the esophagus, removes a bit of tissue for biopsy purposes, takes a few pictures, and pulls the tube back out through the nostril. The patient gets to watch it all on a monitor and gets to depart from the procedure with no ill effects.

Traditional esophagus cancer screening involves a similar tube that is inserted through the mouth. Due to the gag reflex, patients are sedated. While there are often no complications from the procedure itself, the intravenous sedation can cause problems.

“You don’t need those risks to see what’s going on,” says one doctor, who reports that esophageal cancer responds very well when caught early by tools like TNE.q

Esophagitis is a condition that happens when the esophagus is inflamed and can cause pain and discomfort when swallowing. This is a common side effect when treated with radiation to the chest and neck area and can also be caused by chemotherapy treatments.

Some ways to help deal with the symptoms of esophagitis:

Read the rest of this entry »

Carbohydrate consumption of Americans has increased over the years and so has the incidence of esophageal cancer. Esophageal adenocarcinoma rose from 2,500 cases per year back in 1973 to nearly 15,000 cases per year in 2001.The study reported by Vijay S. Khiani M.D., of Case Western Reserve in Cleveland, was presented at the American College of Gastroenterology meeting. The investigators found an association between the rising incidence of esophageal cancer in the United States and the increase in U.S. per-capita carbohydrate consumption over the past three decades.

Although the data could not prove a causal link, Dr Khiani noted that a carbohydrate-heavy diet can lead to obesity, which in turn can lead to gastroesophageal reflux disease (GERD). This disease has been linked to a greater likelihood for developing Barrett’s esophagus, a precursor to lower-esophageal cancer.

Dr. Khiani stressed that the study does not support total carbohydrate avoidance, a strategy promoted by some fad diets. The investigators concluded, “This ecological study provides evidence for the hypothesis that excess carbohydrate intake in the U.S. population may partially account for the increased trend of incidence rates of adenocarcinoma of the esophagus. It is possible that obesity resulting from excess carbohydrate intake many be an intermediate link”.

Studies exist that link acid-reflux conditions to cancer of the larynx — or voice box — but authors of a new study say they all suffer shortcomings in methodology.

The new study, published in the American Journal of Medicine, was intended to make up for these shortcomings by comparing 96 men and women with laryngeal cancer to a group of adults without the disease. All participants were matched by age, gender, and ethnicity — three of the most important risk factors for this cancer. Overall, the study found people with GERD — gastroesophageal reflux disease — were twice as likely to develop laryngeal cancer, compared to those without the condition. GERD has long been considered a possible risk factor for this cancer, mostly because GERD is common among people with the cancer. More definitive studies are on the horizon.

GERD, which occurs when the muscle of the bottom of the esophagus fails to close properly, allowing stomach acids to leak into the esophagus, is also linked to esophageal cancer.

Ann Richards, who was the Governor of Texas from 1991 to 1995, succumbed to esophageal cancer. She passed away at the age of 73. Earlier this year in March, she revealed that she was being treated for esophageal cancer. She was the second woman in history of Texas, to hold that position.

Ann Richards seemed to be a spunky lady. When Ann was nearing sixty she rode a Harley-Davidson motorcycle because she said “I thought I needed to do something kind of jazzy.” Ann didn’t start her political career until she was in her 40’s. She won a seat on the Travis County commission in Austin in 1976. The 1988 Democratic National Convention is when Ann burst onto the scene. At the keynote address she famously described the syntax-challenged Republican presidential nominee, George H.W. Bush, this way: “Poor George. He can’t help it. He was born with a silver foot in his mouth.” She eventually was defeated for the re-election of Governor by Bush’s son, and future president, George W. Bush. That was the last time she ran for office. She then worked as consultant and commentator and she served on corporate boards.

One quote she liked that she said summed up the aspiration of women in politics: “Ginger Rogers did everything that Fred Astaire did. She just did it backwards and in high heels.”

ISLAMABAD: People with low levels of zinc in their tissues may be at increased risk for developing cancer of the esophagus, according to research reported in The Journal of the National Cancer Institute.

In the study, investigators determined zinc levels in esophageal biopsy samples obtained from 132 residents of Linzhou, China in 1985. Of these subjects, 60 subsequently developed esophageal cancer and 72 did not.

People in the highest quartile of zinc levels were 79 percent less likely to develop esophageal cancer than those in the lowest quartile, Dr. Christian C. Abnet, from the National Cancer Institute in Bethesda, Maryland, and colleagues report.

This finding supports studies conducted in animals showing that zinc deficiency enhances the effects of certain nitrosamines, which act as esophageal carcinogens in rodents. While the current findings are interesting, their applicability to US or European populations is unclear, the authors warn. “We did this study in a population that is at extremely high risk for esophageal cancer,” Abnet told. “Also, these subjects in China probably have fairly low zinc intake and tissue levels compared with a US population.” He said his group is interested in conducting a similar study in populations with a lower risk of esophageal cancer and higher zinc levels. “We don�t have any data regarding an association with esophageal cancer in a zinc-sufficient population,” Abnet commented. “It�s possible that once you get above a certain threshold, tissue zinc levels are no longer associated with cancer risk.”

Source:  PakTribune

NEW YORK (Reuters Health) – There is no association between the use of carbonated beverages and risk of subsequent development of cancer of the esophagus as assessed 20 years after the exposure, according to a large population-based study.

“The previously suggested link between the increased use of carbonated soft drinks and the increased occurrence of esophageal adenocarcinoma in western societies was not confirmed in this study,” study co-author Dr. Jesper Lagergren, of the Karolinska Institutet, Stockholm, told Reuters Health.

Lagergren and two colleagues examined data from 189 patients with cancer of the esophagus, 262 with cancer of the cardia — the place where the stomach and esophagus meet — as well as in 820 cancer-free controls. All subjects were interviewed about their previous carbonated beverage consumption.

Users of carbonated soft drinks were not at increased risk of esophagus cancer compared with never users, irrespective of the frequency of consumption, the authors report.

Among high consumers, defined as drinking carbonated soft drinks more than six times per week, there was a trend toward decreased risk of these cancers compared with never users.

Similarly, consumption of carbonated low-alcohol beer did not increase the risk of esophageal cancer.

No association between intake of carbonated soft drinks or low-alcohol beer and risk of cancer of the cardia was observed.

“This study gives no support for the hypothesis that the use of carbonated soft drinks contributes to the increasing incidence of this cancer,” Lagergren and colleagues conclude.

“The fact that risk estimates did not change after adjustment for gastroesophageal reflux or obesity — the suggested mechanisms — provides further evidence against the hypothesis,” they add.

SOURCE: Journal of the National Cancer Institute August 16, 2006.

The addition of further chemotherapy added to neoadjuvant chemotherapy in patients with esophageal cancer can improve survival. When diagnosed with esophageal cancer the patient is usually given chemotherapy to shrink the tumor before surgery, it also may be accompanied by radiation. This gives a better chance that the tumor will be smaller and can be fully removed. It also is treating the body immediately with systematic therapy in case any cancer cells are circulating in the body.The journal Cancer has published an article from researchers at MD Anderson Cancer Center regarding additional chemotherapy added to the neoadjuvant chemotherapy already given to patients who have locally advanced esophageal cancer.

The study included 130 patients with esophageal cancer who received neoadjuvant chemotherapy plus radiation therapy and their outcomes were compared to 117 patients who received the same treatment plus and additional course of chemotherapy (induction chemotherapy) prior to surgery.

At five years overall survival was 43 percent for those treated with the additional induction chemotherapy before surgery, compared to 28 percent for those not treated with induction chemotherapy.

The researchers concluded that the induction chemotherapy added to the neoadjuvant chemotherapy improved survival.

A particular enzyme is significantly higher in cancer cells that have been exposed to acid, leading to the overproduction of hydrogen peroxide, and offering a possible explanation for how acid reflux may lead to cancer of the esophagus, according to a recent study in the Journal of Biological Chemistry.

This press release issued by Eurekalert says that the study found that the enzyme NOX5-S is affected by exposure to acid and that it produces stress on cells, activating genes that lead to DNA damage.

For the first time, researchers have outlined the signaling pathway from cells damaged by acid, to the progression of esophageal cancer. They believe the same process may happen in the body when cells are exposed to acid reflux.

“The role of acid is controversial. But we show that by exposing cells to acid for short periods of time, that affects a particular enzyme, triggering a chain of events that possibly leads to cancer of the esophagus.

Now that we have a better understanding of the signaling pathway, we can possibly identify who is at risk of developing cancer by determining the levels of this enzyme,” says senior author Weibiao Cao, a researcher at Rhode Island Hospital and an assistant professor of medicine and surgery at Brown Medical School.

The study looked at human cancer cells and biopsies from patients with Barrett’s esophagus (BE), a condition where cells in the esophagus have been altered by gastroesophageal reflux disease (GERD), or acid reflux. Acid reflux is believed to be a major risk factor for cancer in people with Barrett’s esophagus.

However, the mechanisms of the progression to cancer have not been fully understood. In this study, researchers found that the enzyme NOX5-S is significantly higher in Barrett’s esophageal tissues, which creates a pre-cancerous condition, as well as in esophageal cancer.

Acid exposure leads to an increase in calcium in Barrett’s esophageal cancer cells, thus activating a cAMP response element binding protein (CREB). This causes the activation of NOX5-S and overproduction of reactive oxygen species (ROS), thereby increasing cell growth and decreasing cell death – optimal conditions for cancer to develop.

It was previously known that levels of ROS are increased in Barrett’s Esophagus and in esophageal cancer and that ROS may play an important role in the development of cancer. However, the sources of ROS had not been defined. Researchers showed that the production of ROS begins with NOX5.

When this enzyme was removed, acid-induced production of hydrogen peroxide was reduced, confirming that NOX5 is responsible. Also, when calcium was removed, the prevalence of NOX5 decreased, along with the production of hydrogen peroxide.

“Now that we know the sequence, we may be able to slow down or even block the progression of cancer by blocking these different steps,” Cao says. “This may have therapeutic value if we can block this particular enzyme, NOX5, in Barrett’s esophageal cancer cells.”

Incidences of esophageal cancer related to BE have increased over the past three decades at a rate exceeding that of any other cancer in the past 10 years. Patients have a poor prognosis, with a median survival of less than 18 months after diagnosis. The five-year survival rate is less than 20 percent after surgery on operable tumors. The major risk factor is gastroesophageal reflux disease (GERD) complicated by Barrett’s esophagus.

Approximately 10 percent of GERD patients develop Barrett’s esophagus. A middle-aged person with BE for 20 years or more has a 10 to 20 percent lifetime risk of developing esophageal cancer, which is similar to the risk of lung cancer among heavy smokers or of liver cancer among chronic hepatitis-B virus carriers.

In order to prevent the progression, it may be necessary to increase treatment with proton pump inhibitors in patients with Barrett’s Esophagus, the authors write.

“Elucidating the pathways leading from acid exposure to increased ROS production, increased proliferation and decreased apoptosis may provide a number of potentially useful therapeutic targets,” the authors write.

Source: Hindu

Japanese-American actor Mako Iwamatsu, who received an Oscar nomination for best supporting actor when he played the Chinese character Po-ha in the 1966 movie The Sand Pebbles, is credited for Hollywood’s acceptance of Asian-Americans as serious actors, not merely caricatures or stereotypes. Last Friday, Mako died of esophageal cancer.

During Mako’s career in film and theater, he co-founded the first Asian-American theater company, East West Players, where he trained aspiring actors and playwrights. Mako had roles in the films Conan the Barbarian, Seven Years in Tibet, Pearl Harbor and the Japanese film Owls Castle.

Mako was the voice of evil demon Aku in the animated series Samurai Jack, and as the parody of Aku, Achoo, in Duck Dodgers, as well as Uncle Iroh in Avatar: The Last Airbender.

According to artistic director Tim Dang of East West Players, “If it wasn’t for Mako there wouldn’t have been Asian-American theater. He is revered as sort of the godfather of Asian-American theater.” Born in Kobe, Japan, Mako was the son of noted children’s book author and illustrator Taro Yashima. He has a star on the Hollywood Walk of Fame. Mako was 72.