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New treatment helps fight esophageal cancer

August 11, 2010 12:00:00 AM PDT
This year more than 16,000 Americans will be diagnosed with cancer of the esophagus -- a deadly disease that starts with something as common as heartburn. For patients, early detection can be the key to survival. Now, researchers are taking a new, less-invasive approach to stop cancer before it has a chance to spread.

Lee Porter loves food, but food doesn't always love him. For 40 years, he lived with painful heartburn that led to an abnormality called Barrett's esophagus.

"It just felt like someone had taken a hot iron and put it down in your throat," said Porter.

When he was diagnosed with early stage esophageal cancer, his doctor told him it could mean removing his esophagus.

"They could go in there and cut you down here and pull your esophagus out and clip it off with scissors, and sew it back up and jam it back in your chest. And I said, 'well, that don't sound like it'd be very much fun,'" Porter recalled.

The Mayo Clinic offered him a less-invasive alternative -- endoscopic mucosal resection.

Doctors enter the esophagus through a special, high-definition endoscope. They locate the cancer and suction the tissue into a special device that shaves off the cancer.

"We place a little band around the base of the cancer, and then we use this special cutting instrument, called a snare, to resect that cancer," said Michael Wallace, MD, Professor of Medicine and Chair, Division of Gastroenterology and Hepatology at the Mayo Clinic in Jacksonville, Fla.

Studies showed the new, less-invasive treatment was just as effective as removing the esophagus for early-stage cancers. Patients who undergo full removal spend days in the hospital and face lifelong eating restrictions. The new procedure is an out-patient procedure, and patients can eat full meals two days later.

After surgery and successful treatment, Porter's back in the kitchen, grateful to be cancer- and heartburn-free and enjoying every bite.

About 10 percent of patients with chronic acid reflux develop the tissue changes that can lead to Barrett's esophagus and eventually cancer.

EXTRA INFORMATION:

BACKGROUND: According to the National Cancer Institute, esophageal or throat cancer, is a cancer that forms in tissues lining the esophagus, the muscular tube through which food passes from the throat to the stomach. There are two types of esophagus cancer: one that begins in flat cells lining the esophagus and the other that begins in cells that make and release mucus and other fluids.

Symptoms can be as common as heartburn, but most symptoms include difficulty swallowing, losing weight without trying, chest pains and fatigue. It's not clear what causes esophageal cancer. It occurs when cells in your esophagus develop errors in their DNA. The errors make cells grow and divide out of control. It's estimated that more than 16,000 Americans will be diagnosed with esophagus cancer in 2010 and that there will be more than 14,000 deaths as a result of this. What treatments you receive for esophageal cancer are based on the type of cells involved in your cancer, your cancer's stage, your overall health, and your own preferences for treatment. The most common forms of treatment include surgery, chemotherapy and radiation.

NEW ENDOSCOPIC TREATMENT: Researchers at Mayo Clinic are taking a less-invasive approach to stop the cancer before it spreads. This approach is called Endoscopic Mucosal Resection. According to Mayoclinic.com, EMR is a procedure to remove cancerous or other abnormal tissues from the digestive tract. A long, narrow tube equipped with a light, video camera and other instruments is passed down the throat to reach an abnormality in the esophagus, stomach or upper part of the small intestine. If cancer is present, EMR can help determine if the cancer has invaded tissues beneath the digestive tract lining. Studies showed that the new, less-invasive treatment was just as effective as removing the esophagus for early-staged cancers. Patients who undergo full removal spend days in the hospital and face lifelong eating restrictions, while the new procedure is an outpatient procedure. Patients can eat full meals two days later. Typically, a follow-up exam is performed three months after your procedure to be sure the lesion was removed. Depending on what is found, your doctor will decide when further examinations are necessary.


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