esophageal cancer - survival rate and heredity?

General Questions
#1

A relative was diagnosed with esophageal cancer yesterday. Since then, I’ve been searching the web for information on this disease, and I’ve found a few informative sites. But there are still some questions left open, and I hope you’ll be able to help me out:

  • I can’t find any conclusive data on survival rates. I’ve found some raw data (e.g., the SEER Cancer Statistics Review or the WHO Cancer Mortality Databank), but I seem to be unable to interpret it. What I’d like is something like a probability of being cured, a life expectancy, or a 5-year survival rate. I’ve already noticed that the general outlook is poor, so you can be frank.

  • I can’t find anything on heredity. The patient’s mother died of the same disease, which has her (and her siblings and descendants) worried.

  • What are the methods of early recognition of EC (for the worried relatives), and how good are they?

Now, before you tell me to go ask the doctor: It’s not possible for me, and the patient herself is not very good at either discussing such things with a doctor or at retelling what she was told. I could have asked my own doctor, but I think there’s more combined knowledge on this board.

Oh, and here’s what I can tell you about the patient, if it’s any help: She’s female, white, in her late 50s, a lifelong smoker, of average general health, lives in Germany. The tumor is located right under the larynx (cervical esophagus?), and judging from the doctors’ excitement, it seems to have developed pretty far, though I don’t have a TNM classification. But she’s had major problems swallowing for at least 6-8 weeks (treated for laringitis by the first two doctors!) and can hardly even drink anymore (also lost a lot of weight). So my layman’s guess would be T2 or T3, Nx, Mx, thus stage IIa. They wanted to perform surgery right away, but she refused and is now scheduled for next week, so they seem to be in a hurry. AFAIK, this surgery is the only treatment they’ve planned so far. (They’ll replace some of the esophagus with a piece of intestine.)

Hm, long post. I hope you can come up with some helpful information. Thanks a lot in advance.

Holger

#2

Just wanted to say hang in there.

My grandfather died of it a couple of years ago. It was diagnosed very late though, he knew he was sick but didn’t complain and thought it wasn’t serious. Your best bet for information is contacting one of the cancer associations by e-mail. They can send you information and give you e-mail addresses of specialists. You might want to try some message boards that specialize in the medical fields.

Best of luck, my thoughts are with you and yours.

#3

Look here for some info:
http://www.mic.ki.se/Diseases/c4.html#digestive

#4

Pardon me for heaving this thread back to the top, but I’m still looking for more info, specifically on the questions I asked above. I thought I’d seen a few doctors on this board?

Thanks, funneefarmer, for the kind words. Sorry to hear about your grandfather. I already learned it’s an insidious disease, often diagnosed much too late to be cured. What a shame.

Thanks also, Mjollnir. A couple of those links were quite interesting.

#5

Esophageal cancer has, generally speaking, only about a 10% survival rate if detected in later stages. It is detected early by an examination by an gastroenterologist looking for GERD (Gastrointestinal Esophageal Reflux Disease). Common early symptoms of GERD include these: persistent cough, food backing up in the esophagus, difficulty swallowing, and frequent heartburn. Eating certain types of foods such as chocolate, caffeine, and peppermints, and using alcohol or smoking, in some people disables the valve at the lower end of the esophagus, allowing stomach acid to back up into the esophagus. This is known as reflux. If you frequently have heartburn and or any of the other symptoms mentioned and ignore it for years, this can lead to what is known as Barrett’s esophagus, which causes the cells lining the esophagus to change and become “pre-cancerous.” Over time, the acid also eats away at the valve promoting additional reflux. Barrett’s in and of itself does not always lead to cancer but is a serious warning flag, and they will do a biopsy if it is detected.

Typical diagnosis involves doing an endoscopy of the esophagus with a small video camera to examine the lining. Treatment takes two forms. The first is pharmaceuticals, typically drugs like Prevacid or Prilosec. These work like profound antacids, which almost eliminate stomach acid so that there is no longer a problem. In very serious cases, there is an operation called a Nissen fundiplication which involves tying the stomach back around the diaphragm in such a way that the acid can no longer reflux back up into the esophagus. This operation fell out of favor in the 1960’s because of the availability of better antacids, and some doctors still believe that it is not a good operation. However, many gastroenterologists now believe that the reason Nissen fundiplication did not always work 30 years ago was that only certain types of patients are suitable candidates for the procedure, and back in the 1950’s, they did not have a good method of selecting suitable candidates. Nowadays, they do a 24-hour Ph study of your stomach by dropping a probe in there connected to a little monitoring device which you wear for a day. This method has been shown to be effective for selecting suitable candidates for the operation.

#6

I just saw a segment on this on the “20/20” tv show last night, where they talked about early warning signs, treatments, etc. (though I don’t remember them saying anything about heredity). It’s not exactly the most comprehensive source, of course, but you could contact ABC for a tape or a transcript of the program.

#7

rfs001
quite a lecture for your second post! You might think of a more memorable board name, though, at this early point. Or maybe not.Just a suggestion.

#8

My sister-in-law has just been diagnosed with pancreatic cancer and like you, I have been looking for information. It does seem to be hard to find answers to specific questions.

One good place (and forgive me, but I didn’t bookmark it) I found through CNN’s website. There had been a report on CNN about a new study on pancreatic cancer and after reading the stuff on CNN I kept following links until I found some more good information. There was even a discussion board on (I think) the Johns Hopkins Institute site.

Maybe you could try something like that?

#9

Sorry to join in this so late - here’s are 2 excellent reviews:
http://www.mayohealth.org/mayo/9910/htm/esoph.htm (short, layman’s terms)
http://www3.cancer.org/cancerinfo/documents/overviews/esopover.asp?ct=12 (really in depth, a little more advanced vocabulary)

In any case, esophageal does not seem to be hereditary. Major risk factors are smoking & alcohol use, both of which promote reflux, which is also a major risk factor. Blacks appear to have a 3-fold higher risk than whites.

Hope this helps.

Sue from El Paso

Experience is what you get when you didn’t get what you wanted.

#10

Thanks a lot, guys. Good to know that EC is not hereditary, but I wonder why I didn’t find that piece of information in all the material I’ve scanned.

BTW, my relative has finally been told how long her doctors expect her to live: three years at most. And she’ll get chemo and radiation therapy after all. The worst part is the panic and officious concern by her brothers and sisters…

#11

I’m sorry the cancer wasn’t detected sooner. My mom had her esophagus removed last month because she had developed high grade dysplasia (pre-cancerous cells) after being diagnosed with Barrett’s esophagus a couple of years ago. Fortunately, her gastroenterologist decided to do some biopsies after her last endoscope, which is how the dysplasia was detected. She doesn’t need chemo or radiation. I saw the Dateline episode or 20/20–whatever it was. They said the 5 year survival rate, once cancer has developed, is only about 5 percent. As far as the friends and relatives go, if any of them have severe heartburn or problems eating, they should see their doctor ASAP. Good luck.