More tests needed for oesophageal cancer patients

March 1, 2011, University of Adelaide

A University of Adelaide medical researcher says current treatment for people diagnosed with oesophageal cancer could be improved with additional pathology tests.

Dr Sarah Thompson, a surgeon and PhD candidate, says tiny cancer cells are being missed in routine pathology examinations, resulting in half of patients who have been given the "all-clear" dying within five years.

In a study of 250 oesophageal cancer patients in Adelaide over the past 10 years, Dr Thompson found that of the 119 people given a clean bill of health, only 62 were still alive five years later.

"If you tell people they are totally clear of cancer and then a year later they come back with secondary cancer, that is a devastating result," she says.

More than 1000 people are diagnosed with cancer of the oesophagus in Australia each year. There are two types: , occurring in the top part of the oesophagus; and , which is closer to the stomach. The latter has increased by 400% in Australia since the 1970s.

Dr Thompson's study showed that oesophageal tumour cells are being missed in the in conventional pathological tests.

"Pathologists normally take just one cut from a lymph node when testing for cancer and this is usually sufficient. But our research has shown that in one third of cancer patients with negative nodes, small cancer cells will be present. These are only visible with special stains and at least three cuts of the node," Dr Thompson says.

"A controversy in the medical world, as far as predicting cancer survival rates, is whether or not those tiny, single mean anything. Some medical experts believe these cells are just in transit and passing through our . Others think if they are present in the lymph nodes these patients should be offered chemotherapy as a matter of course."

Dr Thompson says the oesophageal cancer patients who have the most to gain are those who have had surgery without chemotherapy or radiation beforehand to shrink the tumour.

"Chemotherapy after surgery might improve their survival."

"I think there is also merit in changing the existing pathology guidelines for oesophageal to ensure a more accurate diagnosis. Further sectioning and staining of the lymph nodes should be carried out if the lymph nodes are negative after only one cut to rule out the presence of isolated ," Dr Thompson says.

Her findings have been published in the Annals of Surgery in an article co-authored by Dr Thompson's PhD supervisor Professor Glyn Jamieson, the Dorothy Mortlock Professor of Surgery at the University of Adelaide.

Related Stories

Recommended for you

Study tracks evolutionary transition to destructive cancer

February 23, 2018
Evolution describes how all living forms cope with challenges in their environment, as they struggle to persevere against formidable odds. Mutation and selective pressure—cornerstones of Darwin's theory—are the means ...

Researchers use a molecular Trojan horse to deliver chemotherapeutic drug to cancer cells

February 23, 2018
A research team at the University of California, Riverside has discovered a way for chemotherapy drug paclitaxel to target migrating, or circulating, cancer cells, which are responsible for the development of tumor metastases.

Lab-grown 'mini tumours' could personalise cancer treatment

February 23, 2018
Testing cancer drugs on miniature replicas of a patient's tumour could help doctors tailor treatment, according to new research.

An under-the-radar immune cell shows potential in fight against cancer

February 23, 2018
One of the rarest of immune cells, unknown to scientists a decade ago, might prove to be a potent weapon in stopping cancer from spreading in the body, according to new research from the University of British Columbia.

Putting black skin cancer to sleep—for good

February 22, 2018
An international research team has succeeded in stopping the growth of malignant melanoma by reactivating a protective mechanism that prevents tumor cells from dividing. The team used chemical agents to block the enzymes ...

Cancer risk associated with key epigenetic changes occurring through normal aging process

February 22, 2018
Some scientists have hypothesized that tumor-promoting changes in cells during cancer development—particularly an epigenetic change involving DNA methylation—arise from rogue cells escaping a natural cell deterioration ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.