New Hope for Better Treatment for Rising Esophageal and Upper Stomach Cancer

Prompted by large increases in esophageal and upper stomach cancer incidence during the past four decades (up 50% in UK men and 20% in UK women since the 1970s), the research group has been working for the past 5 years to improve the treatment of gastro-esophageal cancer.

With a belief that these rapid increases are due to diet and lifestyle changes during that time, this latest research is “aimed at providing a better treatment and prognosis for a cancer that is historically not survivable past five years from diagnosis,” as the “standard treatment for potentially operable cancer consists of a 12 week intensive course of powerful chemotherapy, followed by surgery if the tumour is operable, and then a second 12 week course of chemotherapy. This prolonged, intense course of chemotherapy treatment is potentially toxic, impacts on quality of life and is likely to be beneficial only in those patients who respond to chemotherapy.” In fact, the current study found that just 40-50% of adenocarcinomas of the esophagus or upper stomach respond to chemotherapy.

However, the Nottingham-based team has “effectively tested a very promising monitoring test during treatment so that doctors can assess whether and how far the tumour is regressing during chemotherapy. In addition, the research has also identified a promising protein marker involved in DNA repair in cancer cells that predicts resistance to chemotherapy in tumours.”

The finding could lead to the future ability of physicians to determine whether a second course of chemotherapy following surgery is justified, as well as more specialized trails for gastro-esophageal cancers that monitor patients in real time as opposed to using past samples, thus leading to new combinations of chemotherapy.

Dr. Madhusudan, Clinical Associate Professor & Consultant in Medical Oncology, Nottingham University Hospitals and School of Molecular Medical Sciences, said: "Recent scientific advances have given real hope for patients with gastro-oesophageal cancers. The Nottingham Upper Gastrointestinal Cancer Group is a multidisciplinary research team consisting of Oncologists, Surgeons, Pathologists and Radiologists. We aim to exploit the 'new science' for patient benefit. This study published online today in the British Journal of Cancer provides evidence that it may be possible to tailor gastro-oesophageal cancer treatments based on 'new' biology. We are planning a larger prospective multicentre study to confirm these findings and we believe will have major clinical impact on how we treat these aggressive tumours in the future.”

British researchers from the University of Nottingham and Nottingham University Hospitals have said that poor diet, high alcohol consumption, smoking, and increasing obesity could be leading to an epidemic of esophageal and upper stomach cancer.