A study suggests having chemotherapy
before surgery to remove a tumor may benefit more patients with esophageal
cancer than previously thought.
Previous studies have already
established that giving chemotherapy before
surgery can benefit patients with esophageal cancer
by shrinking their tumors.
But as well as these patients, the
new study shows that even those whose tumors do not shrink may also benefit,
because the pre-op chemo can reduce the spread of the cancer to the lymph
nodes. The study shows that when spreading
to the lymph nodes was reduced, this had a knock-on effect of improving
survival and lengthening time to relapse.
We still don't know why some
patients respond to chemotherapy, and others don't. But this study suggests
that more patients than previously thought do benefit from chemotherapy before
surgery, which means that having more treatment after their operation might
also work for them too.He and his colleagues also believe having more chemo
after surgery would benefit such patients even further.
An
aggressive cancer with a very poor prognosis
Esophageal cancer is an aggressive
cancer with a very poor prognosis. The cancer forms in the lining of the
esophagus or gullet, the pipe that passes food from the throat to the stomach.The
cancer is more common in people who smoke, drink alcohol, are overweight and
whose diet is poor in fresh fruits and vegetables.
The Cancer Institute
estimates that 18,980 people will be diagnosed with the disease and 16,210
will have died of it in 2014
In the UK, where around 8,500 new
cases are diagnosed every year, esophageal cancer is the ninth most common
cancer, and the sixth most common cause of cancer death.
Study
investigated 200 patients with adenocarcinoma
There are two types of esophageal
cancer, squamous cell carcinoma, which starts in the flat cells in the gullet
lining, and adenocarcinoma, which starts in cells that make and release fluids
like mucus.
Average time to relapse extended
from 1 to over 5 years
However, in the patients who had the
pre-op chemo but whose tumors did not respond, there were 30 individuals who
showed a reduction in the number of lymph nodes with cancer in them. And
this group showed an increase in the average time to relapse from just under 1 year
to over 5.5 years.
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