Tho't provoking article by Erma Bombeck & European trial results re breath test that detects EC w/o

LorettaMarshall

Hello my fellow Cancer sisters, brothers, family members & friends:

Aren’t we all wishing some new research would come along that would give us some hope, for both those actively coping with Esophageal Cancer, as well as a preventative kind of test that could be administered for those having symptoms associated with Esophageal Cancer? This European study cited below my name, sounds hopeful, and one could only hope that it would soon become a part of a workup for those suspected of having Esophageal Cancer.  After all, heartburn can cause cancer, and so many people just consider it a “normal” thing.  Ever since my husband had a persistent HICCUP and I insisted that we see our GP, we’ve come to know just how few symptoms one can have, and yet really have Esophageal Cancer.

We are ever grateful to Dr. James D. Luketich at the University of Pittsburgh Medical Center who is the pioneer of the Ivor Lewis Minimally Invasive Esophagectomy.  It consists of Band-Aid size cuts and is totally laparoscopic.  Originally there was one slightly larger incision that was made in the neck through which the diseased Esophagus would be removed.  This “neck” incision always carried with it the risk of damage to the laryngeal and pharyngeal nerves.  However, Dr. Luketich has found that by making that incision in the right side of the chest and lower down instead, potential damage to these nerves has decreased dramatically. 

Truly we thank God that my husband William is now in his 14^th year of survival with thus far no evidence of disease.  But we must say we never consider ourselves “out of the woods” because of the “R” word—recurrence possibilities.  But surviving this long after his initial diagnosis of Adenocarcinoma at the Gastroesophageal junction, (T3N1M0) we no longer take life and good health for granted.  All too often many of us make plans for things we want to accomplish, always confident that there will be a “tomorrow”.  Oh sure we all cope with the flu, common colds, occasional hernias, and perhaps broken limbs, but nothing out of the ordinary that can’t be “fixed.”  And then, out of the blue, we find ourselves with a cancer diagnosis that we’ve never heard of and can’t even spell!  And then we come face to face with reality.  We’re thrust into another exclusive club which we never wanted to join. 

My original intent was to just share with you the interesting article about a breath test that one could have without having to have an Endoscopy, but now I think I should add Erma Bombeck’s perspective on life once she was diagnosed with cancer.  It is so true, and before both my husband and I were diagnosed with cancer—he first in 2002, and I, in 2012, we always had plans for “tomorrow.”  So I think I will put a piece that she wrote here as well as the article about the breath test currently in the “trial stage.”    That would be wonderful if we could duplicate that “breath test” here in the states.  Just think of how many could benefit by having this test.  So many more might be diagnosed at a much earlier stage if we had some kind of test.  It could serve as a “pre-emptive” strike.

In any event, Erma’s piece, “IF I HAD MY LIFE TO LIVE OVER” gives us a lot to think about, and helps us put our lives in perspective.  And for all who are putting off doing something, or going somewhere you’ve always wanted to go, if you have the health, NOW would be a good time to do it, don’t you think?  That is, if you can “work it in” between treatments and doctor’s visits.

Sincere best wishes for all EC patients, family members and caregivers.

Loretta – (Wife of William Marshall who was first diagnosed @ age 65~EC Stage III (T3N1M0)~ ~Pre-op chemo of Carboplatin/5FU plus 25 treatments of radiation~then Minimally Invasive Esophagectomy (MIE) @ UPMC on May 17, 2003~performed by Dr. James D. Luketich)

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1. http://www.imdb.com/name/nm0093571/bio       (Erma’s biography)

“IF I HAD MY LIFE TO LIVE OVER

If I had my life to live over, I would have talked less and listened more.

I would have invited friends over to dinner even if the carpet was stained and the sofa faded.

I would have eaten the popcorn in the 'good' living room and worried much less about the dirt when someone wanted to light a fire in the fireplace.

I would have taken the time to listen to my grandfather ramble about his youth.

I would never have insisted the car windows be rolled up on a summer day because my hair had just been teased and sprayed.

I would have burned the pink candle sculpted like a rose before it melted in storage.

I would have sat on the lawn with my children and not worried about grass stains.

I would have cried and laughed less while watching television - and more while watching life.

I would have shared more of the responsibility carried by my husband.

I would have gone to bed when I was sick instead of pretending the earth would go into a holding pattern if I weren't there for the day.

I would never have bought anything just because it was practical, wouldn't show soil or was guaranteed to last a lifetime.

Instead of wishing away nine months of pregnancy, I'd have cherished every moment and realized that the wonderment growing inside me was the only chance in life to assist God in a miracle.

When my kids kissed me impetuously, I would never have said, "Later. Now go get washed up for dinner."

There would have been more "I love you's"... More "I'm sorry’s" ...

But mostly, given another shot at life, I would seize every minute... look at it and really see it ... live it...and never give it back.”

 (Written by Erma Bombeck after her Breast Cancer Diagnosis)

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2.http://www.eccocongress.org/Global/News/ECCO2017-News/2017/01/ECCO2017-NEWS-Breath-test-could-help-detect-stomach-and-oesophageal-cancers

 ECCO2017 NEWS: Breath test could help detect stomach and oesophageal cancers

Amsterdam, The Netherlands: A test that measures the levels of five chemicals in the breath has shown promising results for the detection of cancers of the oesophagus and stomach in a large patient trial presented at the European Cancer Congress 2017 ^[1].

Together, stomach and oesophageal cancer account for around 1.4 million new cancer diagnoses each year worldwide ^[2]. Both tend to be diagnosed late, because the symptoms are ambiguous, meaning the five-year survival rate for these two types of cancer is only 15%. The new research, involving more than 300 patients, showed that the test could diagnose cancer with an overall accuracy of 85%.

Dr Sheraz Markar, an NIHR Clinical Trials Fellow from Imperial College London, under the supervision of Professor George Hanna, told the Congress: “At present the only way to diagnose oesophageal cancer or stomach cancer is with endoscopy. This method is expensive, invasive and has some risk of complications.

“A breath test could be used as a non-invasive, first-line test to reduce the number of unnecessary endoscopies. In the longer term this could also mean earlier diagnosis and treatment, and better survival.”

The trial was based on the results of previous research that suggested differences in the levels of specific chemicals (butyric, pentanoic and hexanoic acids, butanal, and decanal) between patients with stomach or oesophageal cancer and patients with upper gastrointestinal symptoms without cancer. The new research aimed to test whether this ‘chemical signature’ that seemed to typify cancer could be the basis of a diagnostic test.

In the new study, the research team collected breath samples from 335 people at St Mary’s Hospital, Imperial College Healthcare NHS Trust; University College London Hospital; and the Royal Marsden Hospital, London. Of these, 163 had been diagnosed with stomach or oesophageal cancer and 172 showed no evidence of cancer when they had an endoscopy. All the samples were analysed with a technique called selected ion flow-tube mass spectrometry, which is able to accurately measure small amounts of different chemicals in mixtures of gases such as breath.

Researchers measured the levels of the five chemicals in each sample to see which ones matched to the ‘chemical signature’ that indicated cancer.

The results showed that the test was 85% accurate overall, with a sensitivity of 80% and a specificity of 81%. This means that not only was the breath test good at picking up those who had cancer (sensitivity), it was also good at correctly identifying who did not have cancer (specificity).

Dr Markar said: “Because cancer cells are different to healthy ones, they produce a different mixture of chemicals. This study suggests that we may be able detect these differences and use a breath test to indicate which patients are likely to have cancer of the oesophagus and stomach, and which do not. However, these findings must be validated in a larger sample of patients before the test could be used in the clinic.”

Over the next three years, the researchers will continue with a larger trial, using the test with patients who are being given an endoscopy for gastrointestinal symptoms but not yet diagnosed with cancer. This will assess the ability of the test to pick up cases within a group that is likely to contain only a small percentage of cancers.

The team is also working on breath tests for other types of cancer, such as colorectal and pancreatic, which could be used as first-line tests in general practice surgeries.

(ends)

Abstract no: 6 LBA Proffered Papers: Gastrointestinal Malignancies - Upper GI, 09.00 – 10.25 hrs
(CET) Monday 30 January 2017, Room Varmus.
[1] The European Cancer Congress is the only truly multidisciplinary oncology congress in the world. It is organised by the European CanCer Organisation (ECCO), a not-for-profit federation of 25 member societies, representing over 80,000 professionals working in cancer.

[2] According to Cancer Today, oesophageal cancer is the eight most common cancer in the world with an estimated 456,000 new cases in 2012, and causing 400,000 deaths a year. For stomach cancer, there are 952,000 new cases and 723,000 deaths. Cancer Today (formerly Globocan): http://gco.iarc.fr/today/home

[3] Dr Sheraz Markar was funded by the National Institute of Health Research (NIHR). This research was also supported by the NIHR Diagnostic Evidence Co-operative London at Imperial College Healthcare NHS Trust.

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